22 Apr 2026, Politico: Georgia Democratic Rep. David Scott, 80, has died

Rep. David Scott (D-Ga.) has died at the age of 80, according to Rep. Gregory Meeks (D-N.Y.), who disclosed his death at a committee hearing on Wednesday, and a number of other lawmakers.

First elected to the state Assembly in Georgia in 1974, Scott’s career in politics spanned decades. The 12-term lawmaker became the first Black chair of the House’s powerful Agriculture Committee when he was tapped to lead the panel in 2020.

Scott’s death leaves Congress at 218 Republicans and 212 Democrats, with five vacancies. Georgia Gov. Brian Kemp, a Republican, will have 10 days to call a special election to fill the vacancy in the deep blue seat.

Scott is the fifth sitting House member to die this Congress, following Doug LaMalfa (R-Calif.), Raul Grijalva (D-Ariz.), Sylvester Turner (D-Texas) and Gerry Connolly (D-Va.).

Scott faced criticism for seeking reelection in 2024 even as declining health imperiled his ability to negotiate a $1.5 trillion farm bill. Scott was also seeking reelection to his Atlanta-area district later this year. He was already facing a number of primary challengers — including state Rep. Jasmine Clark, who had far outraised him this cycle.

I will get to the Congressional deaths in a moment, but let’s look at Congressional vacancies for just a bit.

Current (and Past) Congressional Vacancies for the 119th Congress (2025-2026)

Ballotpedia is the go-to source for this information:

Current Vacancies (all House)

There are no vacancies in the Senate, currently.

Prior Vacancies (House)

Prior Vacancies (Senate)

The West Virginia one is a little odd — Joe Manchin ended his term on time; his successor was delayed in being sworn in, because he wanted to fill out his time as WV governor. He could have let the Lt. Gov. take those 11 days, but whatever.

Maybe he needed the pension credit time or something.

In any case, we already had three deaths in the House in 2025, which I wrote about here:

I was getting a little exasperated about the situation, because there was no grand conspiracy.

Okay, let me get into this, because some people are trying to make this “a thing”.

They do not understand how high mortality rates are for people are above age 65, and how rapidly it climbs with age, yes, even for people within Congress.

The ages of the people who died in 2025, in no particular order:

• Gerry Connolly: 75

• Sylvester Turner: 70

• Raúl Grijalva: 77

I had been grabbing my head, because THESE PEOPLE AREN’T YOUNG.

It does not require a conspiracy that older people die, especially when you’ve got a lot of old people around.

Randomness is usually clumpy

Yes, sometimes the events will clump, because yes, random events do that, and no, you probably don’t have a good idea of what random looks like.

Here, go watch a video:

Okay, maybe don’t watch that unless you know something about Poisson processes and the exponential distribution, because it assumes you know properties about both. (And if you do, the proper way to have tested the interarrival time would be to have showed up, and recorded the arrival times of the next two buses, not ask somebody when the last bus arrived… and now you know.)

The relevance of a Poisson process is that a completely random Poisson process, even with a constant parameter, will produce clumping:

Poisson clumping is used to explain marked increases or decreases in the frequency of an event, such as shark attacks, "coincidences", birthdays, heads or tails from coin tosses, and e-mail correspondence.

That is poorly written.

Unfortunately, I cannot access the earlier sources in the footnotes, which may have been better written.

The “clumping” that needs to be explained is the pattern-seeking that is within the human brain, where people seek to find structure where none exists.

There is a model — tendency to die, which increases with increasing age (with a gap between the sexes) — but many people find that insufficiently compelling.

Three deaths in a row — IT MUST MEAN SOMETHING!

Rep. Scott was 80, and people had already been commenting on his health in 2024. His district is a lock. I doubt anybody will be screaming conspiracy.

Updating the Congressional Stats

This is just to keep the tables and graphs updated:

Spreadsheet

House Deaths And Demographics 2026 04 22

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Related Posts

• 9 Jan 2026: Congressional Mortality 2026 Update: More Consequences

• 16 Oct 2025: Falls are Dangerous: RIP, Ace Frehley and Watch Out, Sen. McConnell

• 5 Sep 2025: Political Candidate Deaths: Seven German AfD politicians die within weeks of each other ahead of elections

• 25 May 2025: Political Mortality Update: Yes, A THIRD Democratic Representative Died in 2025

• 10 Apr 2025: Congressional Mortality Has Consequences

• 20 Jan 2025: Falls are Dangerous for Seniors: Nancy Pelosi and Pope Francis

• 25 Jan 2025: 2025 Update on Senate Demographics

• 20 Jul 2024: RIP, Rep. Sheila Jackson Lee: An Update on Pancreatic Cancer Death Trends

• Sep 2023: Politicians: Don’t Tempt the Reaper

• Feb 2023: Senate Mortality 2023: Top Ten Old Senators

• April 2022: All Men Must Die, But They Don’t Have to Die in Office

• May 2023: A Sampling of Political Mortality

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16 Apr 2026, CBS 58 Milwaukee: Man dies of suspected lightning strike in Pewaukee parking lot

PEWAUKEE, Wis. (CBS 58) -- A man in his 40s died of a suspected lightning strike Wednesday, April 15, after being found unresponsive in a Pewaukee Kwik Trip parking lot during severe storms, according to police.

The man was identified by family to be 41-year-old Peter Paul Garamone Sr. He was a long-haul trucker from Pennsylvania with a wife and son.

….

Waukesha police say preliminary information indicates Garamone was struck by lightning while walking through the parking lot. He reportedly called first responders when it happened and later died at an area hospital.

This is the first fatal lightning strike in the United States of 2026. It is also the second lightning fatality in Wisconsin in the last seven months.

I will return the geography of lightning strike deaths in a moment.

Deadly Activity: Walking to a Vehicle

Jensenius has kept tabs on the activities of those who died by lightning strike in the U.S., 2006-2025.

With Garamone’s death, “Headed to/from or waiting for vehicle” is tied with “Social gathering”.

People have been struck waiting for a bus, walking across a parking lot (as here), walking from their vehicle to a building, etc.

WHEN THUNDER ROARS, GO INDOORS.

Also: STAY INDOORS. (Don’t go to your vehicle.)

To be sure, being out on open water (fishing or boating) is more dangerous.

2025 U.S. Lightning Strike Fatalities: 21

21 reported deaths, that is.

Now, this doesn’t match the CDC numbers, which, for 2025 (provisionally), are currently 29.

Lightning strike deaths, coded in ICD-10 as X33 (Victim of lightning), are accidental deaths… and are censored for 6 months. The CDC stats are still provisional until they’re finalized either at the end of this year or the beginning of next year.

There are disparities between what’s reported in the news and what is recorded on death certificates, as you can see in the above data.

Either way, 2025 showed an uptick in lightning strike deaths, partly due to a few incidents last year where multiple people were struck.

When the death numbers are so low, and the population of the U.S. is so high, I doubt this uptick is particularly meaningful. Yet.

Geography of Lightning Strike Deaths

Lightning Safety Council map: PDF version with clickable numbers

Inert version:

What is needed for lightning strike deaths is both the lightning and the people to be struck.

I found some great lightning maps at this website: 2025 U.S. Lightning Report

Here is one of their maps from 2025: [this is inert — go to their page to interact]

This is coming from a company that deals with environmental property damage — lightning causes more than just death. Though, livestock death from lightning is a big problem:

2 July 2025, Backpacker.com: A Single Lightning Bolt Just Killed 34 Cows in Colorado. Here’s What Hikers Can Learn.

The sky flashed white, and in a single instant, the whole herd dropped dead. So did their caretaker. Mike Morgan, a longtime Colorado rancher, was feeding his cattle at the time of the strike on Saturday, May 25, and did not survive. While these kinds of lightning-induced mass-casualty incidents are fairly common, the tragedy was the first of its kind in Colorado.

Morgan was standing in the back of a trailer, and the cattle had bunched around him to feed. The close proximity of the animals likely made them particularly vulnerable. Morgan’s wife was leading horses to the trailer at the time, while her father was driving the trailer’s tractor. Both individuals remained uninjured.

George Crocket, a local coroner, told the Colorado Sun that it was the worst lightning strike he’d ever seen in the area. “I’ve seen horses get killed, but it’s usually one at a time,” he said.

How can a single bolt take so many lives?

This isn’t the first time a lightning strike has instantaneously dropped an entire herd. In fact, lightning accounts for about 80 percent of accidental livestock deaths, according to USDA data.

“It is not unusual to have a large group of animals felled by lightning,” Steven Clark, the president of the Lightning Data Center at Lakewood’s St. Anthony Hospital, said in a recent statement. “More often than not, it will be a ground current. In other words, the lightning will hit an object on earth, and the current will flow through the ground and kill the animals.”

….

Farm animals like cows are among the likely to be affected. For one thing, they’re four-legged. That orientation means a current can travel through the ground, up the creature’s forelegs, and down its rear legs. Along the way, the electrical current must pass through the animal’s heart.

Cows also tend to huddle together, which increases the chances that a bolt of lightning flowing through ground will be able to take out multiple animals before the electrical charge has time to disperse and weaken.

….

Agricultural workers—including ranchers, migrant workers, and fieldworkers—are more vulnerable to lightning than almost any other population on the planet. This is especially true in areas of the world where there’s little to no shelter from storms. While the Colorado incident is a sobering reminder of the dangers farm workers face, it also bears some important takeaways for outdoor recreationists.

Hikers are often told they’re safe from lightning as long as they’re not standing on a ridgeline. That’s one of many pervasive lightning myths. This strike took place on flat ground—a reminder that nowhere outdoors is entirely risk-free during a storm. The strike also happened on a summer afternoon—a time notorious for thunderstorms in the Rockies. This critical 12:00 pm to 4:00 pm window is when 70 percent of injurious lightning strikes happen in Colorado.

Notice the relatively high number of lightning strike deaths in Colorado. There are a lot of hikers in the mile-high state.

Unfortunately, if you’re out in the great outdoors hiking, there’s not many choices for shelter if you’re caught unawares by a thunderstorm. They can be a surprise.

Stay safe out there!

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9 April 2026, NY Post: Another mysterious NASA death as ninth scientist linked to secret programs dies [emphasis added]

A NASA scientist mysteriously died without any cause of death listed or autopsy — sparking questions about whether he was part of a pattern of deaths tied to the US space and nuclear program.

Michael Hicks, who worked on a myriad of NASA space science missions, died in July 2023 at the age of 59 and worked at California’s Jet Propulsion Laboratory (JPL) from 1998 to 2022.

He assisted on the DART Project, the Near Earth Asteroid Tracking Project, the Dawn Mission, and the NASA Deep Space 1 Mission.

It is unclear if there’s any foul play linked to Hicks’ death, but his obituary asks for donations in his memory to go to Alcoholics Anonymous. He joins eight other scientists or top officials who have died or disappeared recently.

Before I jump into really digging into this, I’m going to note the increase in alcohol-related deaths during the pandemic, which I wrote about in the following pieces:

• Jul 2025: RIP Michael Madsen: On Heart Disease, Alcoholism, and Men

• Jun 2025: Men’s Health Week 2025: RIP, Brian Wilson and Men’s Mental Health Issues, Drug and Alcohol Use/Abuse

• Mar 2022: Dead is dead: Increased Alcohol-Related Deaths, U.S., 2020-2021

• Mar 2022: Alcohol-related deaths, part 2: Geographical Differences for 2019 and 2020

Here is a graph:

Okay, back to the article, where I will pull out the other 8 people mentioned, in the order they were mentioned.

Monica Reza, JPL’s former director of the Materials Processing Group, disappeared in June 2025 while hiking and has still not been found.

Retired Air Force Gen. William Neil McCasland also disappeared in February, walking out of his home in Albuquerque, New Mexico, without his prescription glasses or phone.

JPL astrophysicist Carl Grillmair was murdered on his front porch in February, and Frank Maiwald, another JPL scientist, died in July 2024 without explanation. Maiwald was a longtime co-worker of Hicks.

Two nuclear workers at the Los Alamos National Laboratory vanished from their homes in 2025 under mysterious circumstances. Anthony Chavez, a longtime worker at the lab, and Melissa Casias, an administrative assistant there, were last seen leaving their homes without critical personal items like their wallets or phones.

Boston fusion energy researcher Nuno Loureiro was killed at his home in December 2025 by former classmate Claudio Neves Valente, who was from Portugal.

Lastly, pharmaceutical researcher Jason Thomas was found dead in a Massachusetts lake last month after also disappearing several months earlier.

He was researching cancer treatments at Novartis.

Okay, do we have the yarn diagram assembled? Are you ready?

I see that Jason Thomas and Nuno Loureiro aren’t on this diagram, but let’s not worry about that right now.

For all this work-up, some of these deaths aren’t mysterious at all (especially the Nuno Loureiro one - that was pretty well-covered when that occurred).

In many of these cases, the details of the deaths aren’t our business, so we’re not being told about them. In others, the reporters are eliding over some salient details to make it seem mysterious.

But let’s look at the oogy-boogy claim:

Former FBI Assistant Director Chris Swecker told the Daily Mail that the cases should be considered suspicious.

“You can say these are all suspicious, and these are scientists who have worked in critical technology,” Swecker told the Daily Mail.

Swecker believes foreign intelligence agencies have been targeting US technology for decades, potentially revealing who could be responsible for the disappearances or mysterious circumstances of scientists and officials.

Ah, Chris Swecker is a fellow North Carolinian! I agree with him that lots of people target U.S. tech.

But, my dude, one need not kill anybody over it. Especially not an administrative assistant.

Oh, and are you aware of how many people work for NASA JPL/LANL? That might be a little bit relevant when it comes to how many people one expects to die/go missing. We’ll be coming back to that number.

Because I want to go back in time… to 2019.

When there was a different “mysterious death” series of stories from the NY Post.

But it didn’t involve NASA.

It involved the Dominican Republic and NY tourists.

STUMP Classics: “Mysterious” Dominican Deaths

Boy, I enjoyed this one. This was the “Mortality with Meep” version of Soda Tax, and don’t worry if you don’t understand that.

There was a bit of a panic in 2019 about people in the NY area vacationing in the Dominican Republic… and DYING! MYSTERIOUSLY!

Here are ALL the posts I did on the situation: [not in chrono order]

• 19 June 2019: Mortality with Meep: How Many Deaths Before it’s No Longer a Coincidence?

• 24 June 2019: Mortality with Meep: People Continue to Die in the Dominican Republic and the PR Problem Continues

• 10 July 2019: Deaths in the Dominican Republic: Westchester Woman Dies

• 5 July 2019: Deaths in the Dominican Republic: Bad Booze?

• 15 July 2019: Deaths in the Dominican Republic: How Many are We Up To Now?

• 20 June 2019: Mortality with Meep: Dominican Republic and Raw Death Rates

• 22 June 2019: Mortality with Meep: Even More Dominican Republic Deaths

Back in 2019, I wrote:

One of the big reasons this is a story is a lot of the people dying are from New York, or the general area. There are a variety of reasons NYers are central to this:

1. There are a lot of Dominicans who live in NYC… so there are a lot of flights from NYC to the DR.
2. A lot of cheap flights to DR, and vacation packages for NYers.
3. A lot of people live near NYC.

I’m no longer going to calculate a damn thing (okay, if somebody else writes a piece that has stats in it, I’ll link, but I don’t feel like calculating any probabilities right now…..

I did do some rough stats in a later post (and now, I have my pal Gemini to help me), but there didn’t seem to be any particular uptick in DR death of tourists, just a media-generated panic.

The problem then was that the DR public relations folks didn’t know how to handle things…

But nobody really has a bias for thinking that somebody is going around murdering Americans in the Dominican Republic.

Let’s think of something that’s far more endemic: antivaxxers. They will not be convinced by numbers. It’s purely emotional reaction at this point.

Truth is one of my highest values, and I have a bias of digging into my assumptions. I am particularly aware of cognitive biases.

But that’s not how most people are (and I wouldn’t even argue that’s how most people should be. I don’t dig into every damn thing myself because it gets exhausting. Somebody needs to make the donuts and not spend time questioning everything.)

So they need to find some good emergency communications people, because this ain’t cutting it.

I agree that the numbers themselves don’t show a problem, but the problem is no longer about the numbers.

I have no recommendation on this score, because this really isn’t something I have expertise about. I can only tell the “you probably won’t die” is not a good message to convey. “Most people survive!” is not any better.

DO BETTER.

Again, that was 2019.

Basically, there wasn’t anything in particular going on, other than perhaps some bad booze/drugs in a few of the cases. Most of the deaths being specified were just accidental deaths, like car crashes. In a few of the cases, people were reaching back to prior years, for no good reason, to try to claim patterns. There was no pattern.

In a year, this frippery was forgotten.

Estimating Death Rates for NASA Employees (and contractors)

So, let’s get back to this “targeting random NASA JPL employees”. [and some other government employees/contractors]

Because it’s not like these people are that closely tied.

Here’s the problem.

How many NASA JPL employees die each year? And LANL? And the contractors?

This is just cherry-picking some of them. This guy Swecker (howdy, fellow Carolinian!) isn’t in the HR department, checking the group life benefits or anything like that.

I had a little chat with my friend, Gemini, with respect to the population we’re drawing from. (And, by the way, why are we throwing in two guys from Massachusetts? Who cares?)

After talking about doing some estimates, Gemini gave this as part of its analysis:

The source given for the workforce composition: Oct 2023, Aerospace America: Advice for NASA on solving its workforce shortage:

Recruiting and hiring skilled engineering workers has become a mission-critical challenge for NASA, an agency of 18,000 employees. An internal review last year of development of the Psyche asteroid probe, now scheduled for launch this month, attributed the project’s one-year delay and cost increases partly to workforce shortages. The review concluded that the problem existed not only at the Jet Propulsion Laboratory in California, where Psyche was built, but also at other of the agency’s 10 field centers.

In recent years, NASA’s average attrition, meaning the percentage of workers who leave the agency, has been around 6% annually, the agency’s acting chief human capital officer told me in a statement. About half of that comes from retirements, meaning the workers who’ve spent their careers there are quickly aging out. NASA is top heavy with older employees too: Nearly 40% of the agency’s science and engineering workers are age 55 and older, according to the April report, “NASA’s Efforts to Increase Diversity in its Workforce,” from the NASA Office of Inspector General.

Now, I did point out that we had a few cases of missing persons and murders (I will get back to one of the murders, which isn’t mysterious):

So we expect there to be a few dozen “external causes of death” among NASA employees/contractors and a few missing persons over three years, according to those statistics.

Here’s the deal (and I didn’t feel like getting into it w/ Gemini) — we all know that missing persons, homicides, etc. are not random, per se.

The person in the lake could be a suicide. The “unexplained” deaths could also be suicides (I don’t know). I bet there were other suicides among NASA employees. They’re not going to tell us the cause of death of everybody — there is privacy.

It’s only in some very public cases that we know details of deaths. Such as murder.

Murder of Nuno Loureiro… and a Couple of Other People Not Mentioned Above

In particular, one of the homicides mentioned in the NYP piece is extremely unmysterious, and the murders of a few other people were involved (not to mention the suicide of the murderer). But the murders of those other people weren’t mentioned… they weren’t tied to NASA, I suppose.

It happened in December 2025, not that long ago… at Brown University. It has its own Wikipedia page: 2025 Brown University shooting

On December 13, 2025, a mass shooting occurred at Brown University in Providence, Rhode Island, United States, during the second day of final examination week for the fall semester.^[7] The shooter, Cláudio Manuel Neves Valente, entered the Barus and Holley Building and killed two students and wounded nine other students^[8] who were attending a review session, and then fled the scene before police arrived.^[9]

Two days later, on December 15, Nuno Loureiro, a Massachusetts Institute of Technology physics professor and former classmate of Valente, was fatally shot at his home in Brookline, Massachusetts.^[10] During a five-day manhunt by the FBI and local police, officials released images and videos of the perpetrator, whose identity was initially unknown to authorities.^{[11][12][13][14]}

Valente was a Portuguese national with United States permanent resident status and a former graduate student at Brown University. On December 18, he was found dead of a self-inflicted gunshot inside a storage unit in New Hampshire.^[15] He was found with two guns; officials said the suicide weapon was the gun used in the Brown University shooting.^[16] Law enforcement agencies alleged him to be responsible for the shooting.^[16]

“Alleged”

If you read the whole thing, they put “speculated” and “alleged” throughout, because “it was never adjudicated!”

My guys, the man (Valente) killed himself. It’s never going to be adjudicated. You don’t have to wait around for a court to tell you what’s true, okay?

Anyway, the issue is that Valente and Loureiro were pretty much from the same university in Portugal as undergrads, came to the U.S. for graduate work, and Loureiro did well for himself, but Valente did not.

Most people who drop out of grad school without achieving their academic dreams just move on with their lives. They certainly don’t go on shooting sprees (especially not decades after they got stuck in loserhood.)

Plenty of losers throughout history have killed people. It’s not a grand conspiracy or a mystery.

The NASA connection is that Lunoeiro’s NASA connection showed he was successful, and Valente was not. That’s it.

That was not a random murder, and that wasn’t a mysterious murder. I wouldn’t factor this into any sort of “expectation” at all.

So that leaves us Grillmair’s murder as “random”, as far as we know. And one “random murder” in a workforce of tens of thousands … and it’s actually not three years (which I will get to in a bit, as well).

Missing People: More Likely to Go Missing in Some Places

What about missing people?

Well, how many people “disappear” in the U.S., and where?

Even without looking at the comments or chatting with Gemini, I can think of lots of reasons for these patterns:

• ALIENS (not a serious answer)

• Highest rates in states with a LOT of empty space, especially desert and tundra (or surrounded by water, in the case of Hawaii) - if someone dies while hiking alone, their body may not be found for a long time

• Higher rates in states with a lot of Native Americans (including Hawaii) - may have all sorts of issues (this is mentioned in the small print)

• “Missing persons” can be code for “missing dead bodies” or can be “people who ran away from unsatisfactory home life…” or “people with marginal living situation to begin with” … lots of stuff going on, and some of these may be more likely to be reported to the cops than others

• Could be Mexican gang activity in some cases, near the border… (or Canadian gang activity, as the case may be)

Alaska has a really high rate and number of missing people. I think we have an idea that these are dead people whose bodies we can’t find. (except in polar bears’ bellies?)

In any case, the NASA JPL and LANL are located out West, and a lot of those people enjoy hiking. Most of the “missing people” cases involving NASA folks may be people who had unfortunate accidents while hiking, and their bodies weren’t found.

We recently had the case of Brian Doherty, who fell while hiking in the Bay Area:

His body was found, but if he had fallen into the Bay and his body never found… it would be a “mysterious disappearance”. As opposed to a tragic accident.

I wouldn’t be surprised that something similar happened in these cases in New Mexico.

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Period of Time? Not Well-Defined Ahead of Time

Here’s the issue with conspiracy theorists, though.

When they go for their “pattern”, they cherry-pick whatever they want, which means they’ll extend the time period to whatever fits their desired narrative.

I was talking about three years above… but if they needed two years or five years or whatever, they’d contract or extend it to that.

People have a very bad idea of what randomness looks like, so it’s easy to take a random sequence and then just look for something in it that looks like a pattern.

“Oh, but these two rare things happened close to one another!”

Yes, I know all about coincidences.

If you don’t define what pattern you’re looking for ahead of time, it is extremely easy to find anything that looks like a pattern. It doesn’t mean it’s connected by any sort of cause-and-effect chain at all.

This is how lots of research projects, even ones that are not outright fraudulent, end up on Retraction Watch.

If you don’t preregister your research, you may just p-hack your way into publishing noise instead of a true signal.

When someone recommended I cover this story of mysterious NASA-connected deaths, someone else commented, “Didn’t The X-Files cover this?”, and I used Gemini to find multiple episodes/story arcs that could fit that… various characters getting killed off or mysteriously going missing to hide government secrets. The first season built up to a finale that was centered around just such a plot.

The X-Files was a work of fiction; it was scripted. It may be nice to think that all of these deaths were connected because THE TRUTH IS OUT THERE and foreign governments are trying to steal secrets about extraterrestrial life (or the cloning thereof… [oops, spoiler]).

But you know, people die every day, and it doesn’t require a large conspiracy.

Alas, We Are All Mortal… and in Large Groups of People, a Lot of People We Know Will Die

I am going to switch to both a happier (and sadder) topic.

I went to high school at the North Carolina School of Science and Math (and then to North Carolina State University). The happy bit is that one of our alumni is on Artemis 2: Christina Koch (both NCSSM and NCSU).

There had been more notable alumni from NCSSM than Koch before, but I think she’s currently the most notable.

Via my alumni connections, over the years, I’ve been able to attend events where Christina Koch was the headliner, such as when she spoke to our alumni groups from the International Space Station (which was super-cool).

Okay, that’s the happy bit. Here’s the unhappy bit.

One of our NCSSM alumni has been keeping death records, to the extent he can. (This is not public, sorry.) We’ve had suicides, homicides, accidental deaths, and natural deaths. Lots of cancer deaths. We don’t necessarily have tabs on everybody, so sometimes he finds out years later that somebody died.

The first graduating class was in 1980, so the oldest people from that class will be turning 65 this year.

Yeah, the rates are going to pick up pretty rapidly.

Some years back, knowing I am a life actuary, he asked me if there was a way I could compare his records against standard U.S. mortality, to see if anything odd was going on. At the time, I told him we didn’t have enough experience to make that comparison. Yet. We need to have a minimum number of deaths (and alumni-years) to test this.

In actuarial work, we call this credibility (and yes, this is related to Bayesian Credibility). You can take a look at the Society of Actuaries’ page: Credibility Methods Applied to Life, Health and Pensions — usually, we want a few hundred deaths to look at.

Nine deaths, as above, even with “weird” causes of death/missing people, is not enough to say something weird is going on, especially in a group of 60,000 people. Especially when these causes aren’t that “weird”.

I hope Christina and crew have a safe landing this evening, but if they don’t, it won’t be because of a conspiracy. It will just be another NASA disaster.

I didn’t mention that one of the people on the Challenger when it exploded in 1986 was an NCSSM trustee. If two people associated with my high school died due to NASA disasters (I hope not), it won’t be random… because it’s not random that a statewide science magnet school has links to NASA programs, and that a risky program has disasters.

I have links to all sorts of notable science/math people because of my high school. This is not random.

I wouldn’t build a conspiracy out of any of this.

Weird Stuff Does Happen… But Be Careful When Investigating It

I can give you the cases of the Russians being poisoned with radioactive isotopes by ex-KGB folks, if you want weird causes of death, but cherry-picking a few nasty deaths/missing cases out of hundreds that happen each year among tens of thousands of NASA employees isn’t that surprising.

So yes, sometimes there are conspiracies to kill people (you can read about the Russian example here in one of the victim’s own books: Allegations by Alexander Litvinenko), but maybe that’s not as exciting as fictional stories of ALIENS.

Now, I’m a regular listener to Jimmy Akin’s Mysterious World podcast, which you may find of interest:

Youtube playlist: https://youtube.com/playlist?list=PLNbswtWzJYCK9g5gYH26HcUC-0hIDlftF&si=q2M8dorSLUbMFL5k

And those are fun stories, but you will find that many of them don’t have much going on other than the desire to believe something interesting was going on, when it was just someone having a bit of fun.

Jimmy tends to be careful in approaching stories (though he does leave some of these open.)

I liked the recent “mysterious shower of meat” episode, and I learned something really interesting from this one. I hope to never run into this phenomenon myself:

May you be able to avoid showers of meat. (Don’t eat meat that falls from the sky, btw.)

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However, they broadly support men’s health issues, which includes testicular cancer… and April is testicular cancer awareness month!

Well, that’s an image.

Testicular cancer is not as common a cancer as lung, breast, prostate, or colorectal cancer. However, it is the most common cancer among young men:

Some key stats from the American Cancer Society:

The American Cancer Society’s estimates for testicular cancer in the United States for 2026 are:

• About 9,810 new cases of testicular cancer diagnosed

• About 630 deaths from testicular cancer

The incidence rate of testicular cancer has been increasing in the US and many other countries for several decades. The increase is mostly in seminomas. Experts have not been able to find reasons for this.

Testicular cancer is not common: about 1 of every 250 males will develop testicular cancer at some point during their lifetime.

1 out of 250 is 0.4% lifetime risk, so obviously that’s very low, and that’s just incidence.

Survivorship is high, if caught early.

But… you actually have to get oddities checked out:

I’ll get back to that in a moment.

Testicular Cancer Survivorship Rates

As with so many other cancers, the statistics look good when the cancer is caught early: [go to link at American Cancer Society for more info on interpretation and data sources]

Heck, those are excellent rates for even distant. It’s probably a reflection of the ages men generally are when the cancers are found (even though these are relative rates):

The average age of males when first diagnosed with testicular cancer is about 33. This is largely a disease of young and middle-aged men, but about 6% of cases occur in children and teens and about 8% occur in men older than age 55.

Improve Your Chances: Check Your Nuts, Go to a Doctor Regularly!

It doesn’t hurt (unless it does, which it shouldn’t… the point of the exercise) to check that everything is as it should be:

Movember: Nuts & Bolts — Lump, swelling or pain: How to check your testicles

What to look out for

Just like any part of your body, nuts can experience an array of very normal changes. Not all irregularities mean cancer. But if you notice a lump on your testicle that wasn’t there before, or are concerned about any pain or swelling, it’s best to let a doctor get up close and personal to see what’s going on.

It’s also a great idea to have a doctor examine your nuts as part of your regular check-up. Find someone that you trust and feel comfortable talking to about all of your health issues — especially the ones you find a little embarrassing.

I think I’ve found something unusual: What should I do?

Okay, so you’ve noticed a swollen testicle, a lump, or your testicles hurt a little — something just feels wrong or unusual. Don’t jump to conclusions about what it means. Instead, take action and see your doctor. Don’t wait around.

Book a doctor’s appointment and get checked out as soon as you can. While it might feel awkward, doctors do checks like this all the time — it’s not awkward for them. They’ll be able to take a look at what’s going on and tell you if they want any tests done to get more information.

One problem has been that males go to the doctor less often than females, even when things may be wrong:

QuickStats: Rate of Visits* to Office-Based Physicians,† By Patient Age and Sex — National Ambulatory Medical Care Survey, United States, 2015

To be sure, a woman’s fertile years may have more cause for more frequent doctor’s visits, and as both men and women age, the visits become more on par… but males still have worse mortality outcomes.

For ages 45-64, far more men are in worse health than women, but you wouldn’t know it from the above graph.

So, guys, just hoping weird lumps will go away is not the best strategy.

Cancer is very treatable, and in many/most cases it won’t be cancer but a different treatable issue.

SEE A DOCTOR, PLEASE.

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The tl;dr: Yes, probably, U.S. COVID deaths were undercounted in those years.

I was not surprised by this claim.

The above graph is from a recent talk I gave to the Iowa Actuaries Club. The reason the deaths are given by quarter is that working actuaries are interested in business results by quarter.

You can see there’s a lot of “extra deaths” that aren’t officially COVID.

To be sure, there was an increase in homicides, motor vehicle accident deaths, and drug overdoses in 2020 and 2021. But even once you take those out, there are a lot of deaths left over, and I knew this — there were recorded increases in deaths due to heart disease, diabetes, Alzheimers, and more. Heart disease had the largest increase in deaths.

But let’s get to the announcements, my guess, the details, and then… “what does this all mean?”

(I don’t think it means what the researchers are trying to claim: what a shock)

News Coverage: More COVID Deaths!

18 Mar 2026, Scientific American: COVID probably killed 150,000 more people in its first two years than official U.S. tolls show

(I added the emphasis)

We have severely undercounted the number of COVID deaths, scientists say

COVID may have killed significantly more people in the U.S. in the first two years of the pandemic than official records indicate, with as many as one overlooked death for every five recorded ones. That brings the total to nearly one million deaths just in 2020 and 2021.

That calculation comes from research published today in Science Advances that seeks to understand how many COVID deaths fell through the cracks of official reporting systems. The untallied cases show the burden of the pandemic in the U.S. fell most heavily on marginalized people.

“These vulnerable groups are just taking a higher risk at every step, and the accumulation of all of that is this disparity in COVID mortality at the end,” says Mathew Kiang, an epidemiologist at Stanford University and a co-author of the study.

In the new research, Kiang and his colleagues analyzed official records published by the Centers for Disease Control and Prevention for deaths occurring from March 2020 through December 2021 for adults aged 25 and older—some 5.7 million records in all. First, they fed a machine-learning algorithm the records of deaths in hospitals, which at the time were testing most patients for COVID. They trained the algorithm to recognize hospital deaths in which COVID was formally identified as an underlying cause. Then they used the algorithm to flag potential unrecognized COVID deaths by identifying records that looked like hospitalized COVID deaths but occurred in other settings where testing was less likely.

All told, the algorithm identified between about 150,000 and 160,000 potential unrecognized COVID deaths on top of the 840,251 that were officially reported. Those numbers suggest that for every five recognized COVID deaths, one additional death went unmarked. That ratio is on par with other analyses that have simply compared the total observed number of deaths with the number of total deaths expected based on historical data, says Daniel Weinberger, an epidemiologist at the Yale School of Public Health, but the new method is both more sophisticated and more granular.

For what it’s worth, we already had enough data to show that more COVID deaths hit “the most marginalized people”.

I will show that in a bit.

That Alabama’s count was way off, according to their model, does not surprise me at all. I have had problems with Alabama data coming through CDC Wonder in the past, and I will leave it at that.

Now, people seeing Alabama, Oklahoma, and South Carolina as the top three in percentage increase by their estimates may make some think this is about politics… but look at the next one.

New York. Way off. Wisconsin is right next to it.

This is not a matter of politics.

It’s a matter of how death certificates and cause of death are generated, and most importantly, how COVID kills.

Who dies and how they die is more to the point.

Interlude: My Reaction When Told, Before Reading the Research

Take a look over my shoulder.

One potential indirect reason for COVID to lead to an increase in deaths due to these causes would be a lack of treatment or neglect of some sort (as many Alzheimer’s patients were in nursing homes).

(Note: the increase for all these causes of death occurred before any COVID vaccines were available, so you can’t use that as a sole explanation for the period.)

That the increase in deaths attributed to these causes was really due to COVID would hardly be surprising.

The Scientific Paper and Model

18 Mar 2026, Science Advances: Applying machine learning to identify unrecognized COVID-19 deaths recorded as other causes of death in the United States

Abstract:

The actual number of US deaths caused by severe acute respiratory syndrome coronavirus 2 infection has been investigated and debated since the start of the COVID-19 pandemic. Here, we use machine learning trained on US death certificates from March 2020 to December 2021 to predict 155,536 (95% uncertainty interval: 150,062 to 161,112) unrecognized COVID-19 deaths. This indicates that 19% more COVID-19 deaths occurred in the US than officially reported. Predicted unrecognized COVID-19 deaths occurred disproportionately among decedents with less than a high school education; decedents identified as Hispanic, American Indian, Alaska Native, Asian, and/or Black; counties with lower household incomes and worse preexisting health; and counties in the South. These findings suggest that the US death investigation system undercounted COVID-19 deaths unevenly, hiding the true extent of inequities.

Let’s look at their figure 1, which shows county-level results of undercounting, based on their model results:

Figure 1 caption:

Fig. 1. ARRs comparing total predicted COVID-19 deaths to those officially reported in each county and state, March 2020 to December 2021.

The ARR shows the extent by which total predicted COVID-19 deaths exceeded officially reported COVID-19 deaths during the period. A limited number of counties had ARRs < 1, which suggests that there were more officially reported COVID-19 deaths than total predicted COVID-19 deaths. One reason that a county could have an ARR < 1 is if death certifiers recorded people as dying from COVID-19 when they had COVID-19 but actually died from another unrelated cause. The map (top) shows ARRs for each county. Counties with missing data had missing county-level covariates that prevented prediction. The forest plot (bottom) shows ARRs for each state, sorted from states with the lowest ARR (e.g., Vermont where there were 24% fewer total predicted COVID-19 deaths than officially reported) to those with the largest ARR (e.g., Alabama where there were 67% more total predicted COVID-19 deaths than officially reported).

ARR is the adjusted reporting ratio, which is (modeling “real” total COVID deaths)/(reported COVID deaths). So if ARR is greater than 1, they modeled more actual COVID deaths than were reported (their most common result).

[I also note that Connecticut’s data is missing on a county level. HUH, CONNECTICUT IS A PAIN WITH DATA IS IT]

Then, there are the causes of death they think are being substituted:

First, there’s the “all other diseases (residual)” — that’s an artifact of the “rankable causes of death list” used by the CDC. This is the leftover category. Everything else gets dumped there. That was 14.5% of the substitution.

For heart disease, we have:

• 63 all other forms of ischemic heart disease: 8.2%

• 68 all other forms of heart disease: 4.9%

• 62 atherosclerotic cardiovascular disease: 4.0%

• 59 acute myocardial infarction: 3.6%

That’s a total of 20.7% — all under heart disease causes (and there are probably more heart disease causes lower down on the list).

What’s interesting about both lung cancer and chronic lower respiratory disease on this list is that overall, those causes had gone down in rate in 2020 and 2021 compared to 2019.

I saw potential problems with the model (and just because those causes of death had gone down overall, that doesn’t mean there couldn’t have been misclassifications elsewhere). I want to point out some weirdnesses I noticed they didn’t address at all, that I saw.

Weirdnesses in the Results: Rural/Urban and Homeownership

Figure 4 caption:

Fig. 4. ARRs comparing total predicted COVID-19 deaths to those officially reported by county of residence characteristics, March 2020 to December 2021.

The ARR shows the extent by which total predicted COVID-19 deaths exceeded officially reported COVID-19 deaths during the period. County characteristics are divided into quintiles, with Q1 representing the lowest values and Q5 the highest values. The specific values for each quintile are included in parentheses. For example, the ARR for Q1 for percent homeowners is the ARR for counties where the percentage of residents who are homeowners is in the lowest 20% of all counties (i.e., counties where between 0 and 66% are homeowners). Figure S2 presents the number of total and officially reported COVID-19 deaths for each category.

So, these are the results they pointed out in Figure 4:

Finding 4: Differences in unrecognized deaths by county characteristics

Our predictions showed that reporting of COVID-19 deaths also varied by county-level characteristics (Fig. 4). COVID-19 deaths were more likely to go unrecognized in counties in the lowest quintile of median household income [ARR: 1.34 (95% UI: 1.31 to 1.36)] and the lowest quintile of the proportion of residents with some or more college [ARR: 1.37 (95% UI: 1.33 to 1.41)]. COVID-19 deaths were more likely to go unrecognized in counties with the most residents reporting poor or fair health [ARR: 1.30 (95% UI: 1.28 to 1.33)] and with a higher percentage of residents living with diabetes [ARR: 1.33 (95% UI: 1.30 to 1.35)]. COVID-19 death reporting accuracy also varied across the rural-urban continuum.

So they pointed out the items that fulfilled their “inequities” narrative that they want to support.

But let’s look at this rural-urban continuum statement at the end.

COVID-19 death reporting accuracy also varied across the rural-urban continuum.

It sure did.

Look at that.

Rural was pretty low in ARR (huge error bars — the samples are rather small, so it makes sense).

The metro areas were fairly moderate in their modeled result for ARR.

But the Urban metro-adjacent, both large and small, had the largest ARRs. I’m developing an alternate hypothesis for undercounted COVID deaths, different from inequity.

It relates to what I know about mortality risk to begin with. Basically — is there anything interesting about the counties near metro counties? They’re not necessarily “marginalized”. But they might have a lot of spillover mortality from an airborne pandemic.

They didn’t address this weirdness at all:

Higher homeownership leads to higher ARR? Huh?

Until you see a map of what homeownership across the U.S. by county looks like:

And now I can tell you about some of the problems with both the model and the data.

But for those who may not know what is going on with the weird-looking results on ARR for homeownership quintiles, and the authors probably know (if they looked into it) — there is a real dichotomy in the counties in Q1 and Q5. The Q1 counties, where homeownership is low, is a bizarre blend of extremely rich and poor populations (and some very sparse populations).

On the page I got the above map from, he listed some notable low-ownership counties:

• Bronx County, New York: 20.3%

• New York County, New York: 24.7%

• Aleutians West Census Area, Alaska: 29.5% (only 288 households)

• Kings County, New York: 29.7%

• Hudson County, New Jersey: 31.2%

• Kenedy County, Texas: 35.3%

• Chattahoochee County, Georgia: 36%

• Suffolk County, Massachusetts: 36.6%

New York County, NY, is better known as Manhattan, and Kings County is Brooklyn.

But more to the point, Los Angeles County, and at least 4 of the 5 boroughs of NYC (Staten Island has a lot higher homeownership than the other boroughs) are in the Q1 — and probably have little undercounting of COVID. If they’re weighting this by deaths overall, the big urban areas will have the most deaths and have the biggest effects. Urban areas have modest ARRs, remember.

What kind of characteristics will the counties with the highest homeownership (over 78%) have?

Pretty much places with very modest real estate costs. Maybe these are non-urban, but adjacent to urban places… did they ever consider that they’re double-counting characteristics?

But I didn’t see anything addressing the odd-looking homeownership results in the paper.

Earlier Publication from the Same Researchers

I thought the concept of capturing the undercounting of COVID deaths via various approaches had been published earlier in a familiar venue, and it had… by the Society of Actuaries in December 2024:

Cause-Specific Excess Mortality During the COVID-19 Pandemic

Four of the authors on the first paper are on this paper, and they go into analyzing reported causes of death, timing, and correlations during the pandemic:

Their appendix has their models used for trying out different approaches to underreporting:

It turns out that correlations showed that for most of their tested natural causes of death, either showed no correlations or peaked in the same weeks as COVID deaths.

Notice both the negative and the positive correlations for “malignant neoplasms”, aka cancer.

All that said, they were using a seasonal ARIMA model to project deaths over the period and to calculated correlations. There can be issues here, in the assumptions underlying what “should” have been the deaths for each of the age groups. But I’ll just accept their modeled results and move on from there, and let’s just say that 20% of the COVID deaths were undercounted, let’s pretend reclassify… and so now what?

Lesson 1: Know your data

The issue, by the way, is not so much the undercounting of COVID deaths.

I always expected that there would be persistent undercounting in the first wave(s), because even as I saw NYC deaths get adjusted over time, and the spike became fewer “heart attacks” (aka acute myocardial infarction) and more COVID-19 listed as the UCD (underlying cause of death) in the initial spike, I was doubtful that the city got that many heart attacks that led to deaths because of an overtaxed hospital system from COVID. It was more likely that blood clots created by COVID caused heart attacks. Similarly for strokes.

Because this is how other causes of death are being recorded for something else that actually caused the situation.

I’m going to jump over to cancer for a moment: in general, when cancer kills you, it’s difficult to miss. The kinds of symptoms cancer gives you right before it kills you are hard to ignore. So perhaps you might get “pulmonary embolism” as a cause of death on the death certificate if it’s not known you have metastatic cancer… but probably the cancer is known, and that will be put down on the certificate.

But with regards to COVID, it can look like so many other things, and the people who usually had fatal results had all sorts of pre-existing poor health, which is why the known poor health condition would be what was recorded instead of COVID. If the person looked like they died due to diabetic complications, diabetes would be recorded. Testing for COVID wasn’t that great early in 2020, so there would be only a guess many times anyway.

Which gets to the main issue: it’s a reminder to KNOW YOUR DATA.

Know how the data are created.

In creating death records, people are involved in judgment calls at multiple points, and the cause of death is the biggest judgment call of all.

Usually, multiple things are going on when people die, and trying to determine the underlying cause of death is really an art. And, let’s be serious, for most deaths, there’s only so much effort going into putting all this data together.

The vast majority of deaths do not involve an autopsy. About the same number of deaths occur in a hospital as at people’s homes. There can be some investigations, but as most people die when they’re old, they generally list the known conditions of the person if it looks like a natural death. They get the information from the person’s physician.

Yes, some states and counties have more resources for medical examiners than others. But the cause of death is not necessarily a huge dispute. Not a lot hangs on it, unless there’s a murder investigation or medical malpractice lawsuit. (disclosure: my family was involved in a med mal lawsuit in my own father’s death. He died of a heart attack at the age of 38.)

But this is why, back in 2020 and 2021, I stopped bothering to count COVID deaths and just counted total deaths anyway.

I did say, Dead is Dead, but I also knew that many of the causes of death would be misclassified.

So let’s look at the patterns overall.

Such as this April 2021 post:

I ranked the states (and pulled out DC and NYC separately), so we could see who had the biggest effects in 2020.

From that post:

But just from a human point of view: dead is dead. If COVID-related policies increased deaths due to drug overdoses and car accidents, that is an important piece of information. Policy choices aren’t made in a vacuum. There are trade-offs.

So I was talking about “external causes of death” — even adding in these supposed COVID death undercounts, there are still plenty of “extra” deaths left over that can be filled in with these.

Lesson 2: Repeating truths is just fine

In the case of COVID, I have been giving presentations on mortality trends before and through the pandemic (and now after), and having conversations with other actuaries where we’ve seen the highest COVID impacts were, other than NYC, it’s where mortality was already bad in a relative sense.

YES, IT WAS PLACES WHERE MORTALITY WAS BAD BEFORE COVID

In case you didn’t hear it the first time.

Places where obesity and diabetes were very high had bad COVID mortality experience.

This is a figure from an archived CDC page on diagnosed diabetes incidence.

Those dark areas in the 2019 map (excluding the missing data for New Jersey - they got hit hard with COVID due to being near NYC) give you an idea of places with excess natural mortality in 2020.

That’s just diagnosed diabetes, of course. If I had a map of obesity, there would likely be an even clearer message.

The argument the authors are trying to make is that the places with the most COVID deaths undercounting were “marginalized”, but I didn’t really get that from their paper.

They’re leaning on an interpretation of county data that’s silly. They should go look at Chicago, which is inside Cook County, and see the disparities within that city to think about what they’re attempting to do. Or maybe walk across Manhattan a few times. I’ve done it. It’s not a big island. Los Angeles is one county. What are the stats about how “marginalized” it is?

The problem is, there are too many confounding factors in their data and model, and I assume they know that. None of the various slices they’re showing is independent. They’re leaning on the county-based model because death data are reported at the county level, and they can get census-type data at the county level as well. But that doesn’t mean they’re really capturing where “marginalized” populations actually are in the U.S.

But let’s move on from there, because I’ve seen the results of such models from before the pandemic.

I’m pretty sure all these authors have published pre-pandemic papers with regard to mortality and these various slices they show above (because it’s very easy to show — you can pick all-cause mortality, or specific causes). Geography, race, education level, income level, homeownership, and on and on.

That said, emphasizing: “Hey, that thing we all knew was true before, continues to be true,” is not a bad message to send.

I’m fine with: “Yes, boring expected result that we knew before did come out in pandemic as it was in the before times.” That’s an important thing to know.

So, the county-level mortality models generally show the same counties having bad mortality experience pre-pandemic and during the pandemic (if you include the whole 2020-2021 period). That’s it.

They don’t really dig into why these disparities exist.

Maybe they should take a road trip sometime, leave the Boston area, and figure out what it’s like in the continent-wide country of ours, and why there are huge disparities in mortality outcomes.

Heck, maybe they can expense a trip to Hawaii, which has had the lowest mortality levels for quite some time (and that held throughout COVID… it’s nice being on an island.)

I will admit to being somewhat limited in experience, mainly going up and down the East Coast, and having grown up in the Southeast. I do have some experience of the West Coast but only for conferences and academic stints. I did like Vancouver (yes, I know it’s not the U.S.)

Lesson 3: Remember There Is a Limit to What We Can Control (At a Given Time)

But the point is this: we track cause of death in health statistics partly to see if there are trends in which we can intervene.

Even with misclassified COVID deaths during the pandemic, there was still clearly heightened “natural” deaths, usually attributed to heart disease, strokes, Alzheimers, and diabetes. Obviously, when a person dies, and people didn’t even know they were ailing from something… how could anybody have intervened?

During 2020-2021, we didn’t have great interventions for COVID anyway, not if you were near death. Heck, Paxlovid wasn’t approved for emergency use until the end of 2021 and then regular FDA approval in 2023.

So trying to be overwrought about “SOMEBODY DOOOO SOMETHING!”, well, people were yelling quite a bit at the time, and not only did we get the COVID deaths, but we also got excess homicides, drug ODs, alcohol-related deaths, and motor vehicle accident deaths out of it, but I’m not going to be too worried that perhaps the increase in heart disease deaths we saw were actually COVID deaths we couldn’t do much about.

Not then, at least.

That’s something to think about.

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14 March 2026, Reason: Brian Doherty, Historian of the Libertarian Movement, Dead at 57

Brian Doherty, a longtime Reason senior editor and the leading historian of the libertarian movement, was found dead Friday morning after a fall the night before in Battery Yates park along the San Francisco Bay. He was 57.

Doherty, who began working at Reason in 1994, was the author of six books, most notably the definitive 2007 study, Radicals for Capitalism: A Freewheeling History of the Modern American Libertarian Movement. Conservative writer Jonah Goldberg called Radicals an “extraordinary accomplishment“; libertarian economist Bryan Caplan dubbed it a “remarkable labor of love.”

Doherty’s other book-length treatments of libertarian phenomena included Gun Control on Trial: Inside the Supreme Court Battle Over the Second Amendment (2008), Ron Paul’s rEVOLution: The Man and the Movement He Inspired (2012), and Modern Libertarianism: A Brief History of Classical Liberalism in the United States (2025).

“Brian was the historian of the libertarian movement,” says Reason Foundation President David Nott. “He lovingly and comprehensively portrayed the colorful characters in the libertarian world.”

I don’t need to know the details of Doherty’s death, but I do know that there are many ways to die from a fall:

Given his age and the location, he almost definitely did not die in the way that the very old die from falls: ICD-10 Code W18: Other fall on same level.

There is also W10, which is falling on stairs/steps, which skews younger, and the method by which Ivana Trump died.

Accidental deaths strike at all ages, but differ by type

But it just so happened I was working on this post already: looking at accidental causes of death in general, which happen at all ages, and extend far beyond falls.

Except during the pandemic, “accidents” have been the #3 cause of death behind heart disease and cancer for quite some time. But the problem is that I know there have been a variety of things in that “accidents” category:

• motor vehicle accidents

• drug overdoses

• falls

• drowning

• fire

• lightning strikes (okay, those are very few….recently)

And there’s much more.

In a post last year, I showed a breakdown of how accidental causes of death differed by age group:

The data were from 2023, and while it’s not surprising that falls were more prominent for the elderly compared to the young:

Given that both death rates due to falls and drug overdoses have been increasing since 1999… perhaps this profile has changed over time?

As well, the sex gap in accidental causes of death is of interest: more males figure in both drug overdose and motor vehicle accident deaths, but not necessarily falls.

Let’s check it out!

For this post, I’m looking at only 1999 and 2024 in statistics. I may look at interim years in future posts,

1999 Accidental Deaths by Sex and Age, U.S.

Count of deaths by sex and age

To make the graphs more directly comparable, I gave them identical vertical scales (within the same year and same metric).

Starting with 1999 as our base year, we’re going to see a pattern of much higher death counts for males in young adulthood compared to females, with both drug overdoses and motor vehicle accident deaths being much higher in count.

You’ll see that accidental deaths for seniors are higher in count for females than males. I’ll comment on that in a moment.

Percentage breakdown of accident type by age group

I’m not doing a detailed comparison of the percentage composition here — there are some differences. While there are far fewer accidental deaths for females in young adulthood, for instance, the percentage that are from motor vehicle accidents versus drug overdoses isn’t that different from that of males.

Rates by age and sex

While there were more accidental deaths for females than males in counts for the age 85+ age group, the rate for males is higher… because there are far fewer males around in that age group (in 1999… and now).

You can also see that even though the number of accidental deaths for males is highest in young adulthood, it is really at the oldest ages that accidental death is highest… driven by falls (and, potentially, other causes in the “all other accidents”, but I’m not digging into this right now).

Let’s jump over the next 25 years and see how the profile differs in 2024.

2024 Accidental Deaths by Sex and Age, U.S.

Count of deaths by sex and age

The first thing you’ll notice is the change in vertical scale.

This doesn’t necessarily tell us anything about rate, given the population of the U.S. is larger.

However, you can also eyeball it and see that drug overdoses are a higher percentage of the deaths in young adulthood:

Percentage breakdown of accident type by age group

Yikes.

Yes, drug overdoses are a much higher percentage of the accidental deaths in young adulthood and through middle age.

As well, falls are a much higher percentage of deaths in old age.

This is not because the rates of these causes dropped.

Rates by age and sex

The drug overdose death rates are much higher than before, for young and middle-aged adults, both males and females. But you can see the death rates due to falls for seniors are much higher, and much higher than what was seen in 1999.

Accidental deaths have been increasing in age-adjusted death rates, and it has been driven more by the increase in drug overdose death rates at younger ages, because age-adjusted death rates are affected more by the increase in death rates at younger ages.

Recently, there has been a decrease in drug overdose death rates — but only on a year-over-year basis. That is, in 2024, drug overdose deaths were lower in count and rate compared to 2023.

But it’s still a lot higher than what we saw in 1999.

Spreadsheet

Accidental Causes Of Death By Age And Sex 1999 2024

798KB ∙ XLSX file

Download

Download

The spreadsheet contains data for all years 1999-2024 on accidental deaths, just FYI. The graphs for 1999 and 2024 are in there, but the data exist for all the years in between.

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This may sound odd coming from somebody living at a relatively high latitude, in New York State, (okay, only 41.35 degrees N, approximately), so I should be one of those who loooooooves getting those clocks changed… right?

NO.

NOT GREAT. THANKS FOR ASKING.

So, with the help of my friend Gemini, I’ve got some new stories about the risks that come from the DST switch! Let’s get to it!

HEART ATTACKS

What great timing! There is the whole GO RED (which I always read as GORED) for Heart Health in March, so let’s see this little heart healthy reminder for DST risks!

3 March 2026, University of Alabama, Birmingham: From the expert: The link between daylight saving time and heart attacks

Many people may groan about losing an hour of sleep this spring, but there may be a more serious reason to be mindful of daylight saving time.

Martin Young, Ph.D., in the University of Alabama at Birmingham Division of Cardiovascular Disease, says springing forward one hour is associated not only with increased accidents, but also increased risk of heart attacks, particularly for people with a history of heart disease.

“Moving the clocks ahead one hour in March is associated with a 10 percent to 24 percent increase in the risk of having a heart attack the following Monday and to some degree Tuesday,” Young said.

Young says many factors may contribute to the increased risk of heart attacks following the beginning of daylight saving time, including loss of one hour of sleep and a misalignment of our internal clock. Every cell in the human body has an internal time mechanism, also known as a circadian clock, which is responsible for driving rhythms in biological processes. These rhythms follow a roughly 24-hour cycle, responding to changes in light and darkness in an organism’s environment.

When these clocks are interrupted or experience a sudden change, there can be several different health effects.

“Going from a sleeping state to waking is already a stressful event in the body,” he said. “When we have an abrupt change, like losing an hour of sleep with daylight saving time, our internal clocks don’t have enough time to reset various biological processes.”

Given there is no real benefit from stealing one hour from us IN MARCH (if you want to do it the Sunday before Memorial Day, okay, why not)… HEY GUYS, MAYBE STOP IT.

To ease the transition, he suggests dividing up the one-hour loss over the course of the weekend. For example, if you usually wake up at 6 a.m. on a weekday, then set your alarm for 5:40 a.m. Saturday, for 6:20 a.m. (new time) Sunday and for 6 a.m. Monday. In addition, eat a decent-sized breakfast, then go outside in the sunlight and exercise, as appropriate and as recommended by your doctor.

I’ve got a recommendation:

LET’S STOP HAVING DST

Or, as a compromise, let’s actually start it in May (I mentioned Memorial Day as a great day for starting) and end on Labor Day. Then we’ll have minimal disruption.

MEDICAL MALPRACTICE

These researchers looked at three decades of medical malpractice claims to see if DST had any effect.

Let’s check.

Journal of Clinical Sleep Medicine, 2024 Jun 1: Medical malpractice litigation and daylight saving time

Methods:

We analyzed 288,432 malpractice claims from the National Practitioner Data Bank. To investigate the acute effects of spring DST transition, we compared medical malpractice incidents/decisions 1 week before spring DST transition, 1 week following spring DST transition, and the rest of the year. To investigate the chronic effects of DST months, we compared medical malpractice incidents/decisions averaged across the 7–8 months of DST vs the 4–5 months of standard time.

Results:

With regard to acute effects, spring DST transitions were significantly associated with higher payment decisions but not associated with the severity of medical incidents. With regard to chronic effects, the 7–8 DST months were associated with higher average payments and worse severity of incidents than the 4–5 standard time months.

Now, this seems less a DST issue and more a seasonal issue of people goofing off in summer.

[Okay, maybe I’m being a little dismissive here… but remember, I am biased to begin with. BIASED AGAINST TORT LAWYERS.

Okay, and biased against bad experimental design.]

Do you notice how long the “DST” period is compared to “ST”?

HOW CAN IT BE “STANDARD” TIME WHEN IT’S SHORTER?

Yes, to be serious for a moment, one of my big beefs with DST is that it was extended too long. This is ridiculous.

Okay, maybe Memorial Day to Labor Day is too short if you’re going to have DST…. but SURELY you can see the current version is too long?

So I don’t think this research paper proves anything re: DST. It looks iffy.

But it has a nice figure, which helps to remind people that DST IS TOO DAMN LONG.

TRAFFIC ACCIDENTS

Okay, a lot is going on here.

First off, thank you, sleep medicine professionals, for covering me re: DST.

It’s not the sleep issues that I hate DST (from a personal perspective) — I am a super duper early-morning person who regularly wakes up at 3 am during Standard Time, so it’s not like I’m thrown off. I am a strange person re: sleep.

But one hour … not necessarily a big deal from a SLEEP point of view.

But it’s not just SLEEP — it’s also the quality of light in the morning, and because I live in the part of the U.S. where the roads are based partly on where native people tracked deer I GET THE FRICKIN SUN IN MY EYES WHILE I’M TRYING TO DRIVE AT A “REASONABLE” HOUR AND I CANNOT SEE A DAMN THING.

YOU PEOPLE.

DO YOU NOT THINK ABOUT THE ANGLE OF THE SUN COMING UP OVER THE HORIZON, GETTING INTO PEOPLE’S EYES?

YOU ABSOLUTE DONUTS

Okay, fine, getting to the data.

American Economic Journal: Applied Economics 2016, 8(2): 65–91 http://dx.doi.org/10.1257/app.20140100

2016, Austin C. Smith: Spring Forward at Your Own Risk: Daylight Saving Time and Fatal Vehicle Crashes

Daylight Saving Time (DST ) impacts over 1.5 billion people, yet many of its impacts on practicing populations remain uncertain. Exploiting the discrete nature of DST transitions and a 2007 policy change, I estimate the impact of DST on fatal automobile crashes. My results imply that from 2002–2011 the transition into DST caused over 30 deaths at a social cost of $275 million annually. Employing four tests to decompose the aggregate effect into an ambient light or sleep mechanism, I find that shifting ambient light only reallocates fatalities within a day, while sleep deprivation caused by the spring transition increases risk. (JEL I12, Q48, R41)

Okay, that paper is a decade old.

Recall that DST alters the risk of a fatal crash in two ways: reallocating ambient light from the morning to the evening; and disrupting sleep schedules. Despite strong evidence suggesting the importance of ambient light in fatal crash risk (Fridstrom et al. 1995, Sullivan and Flannagan 2002), the implication for net crashes due to DST remains unclear. DST does not alter the amount of light in a day, it simply reallocates it between the morning and the evening.

My dude — do you even drive?

You can have an “ambient light”, but if you’re one of those people who has an almost straight east-west commute (or, I should say, on the path that the sun rises or sets, which isn’t perfect east-west, due to the tilt of the Earth), THEN HAVING POORLY PLANNED HIGHWAYS BECAUSE YOU LIVE IN NEW YORK OR CONNECTICUT might be relevant.

Yes, I’ve covered this paper before.

This is old stuff, but the point is there’s a jump in fatal crashes immediately after the switch.

A more recent paper:

Current Biology, 2020: A Chronobiological Evaluation of the Acute Effects of Daylight Saving Time on Traffic Accident Risk

Highlights

•

Spring DST transition acutely increases fatal traffic accident risk by 6% in the US

•

∼28 fatal accidents could be prevented yearly if the DST transition was abolished

•

Spring-DST-transition-associated fatal accident risk is highest in the morning

•

Locations further west in a time zone are affected more by the spring transition

Summary

There is evidence that the spring Daylight Saving Time (DST) transition acutely increases motor vehicle accident (MVA) risk (“DST effect”), which has been partly attributed to sleep deprivation and circadian misalignment [1–6]. Because spring DST also shifts clock time 1 h later, mornings are darker and evenings brighter, changing illumination conditions for peak traffic density. This daytime-dependent illumination change (“time of day effect”) is hypothesized to result in DST-associated afternoon and evening accident risk reductions [2, 5, 7]. Furthermore, sunrise and local photoperiod timing depend on position in time zone. The sun rises at an earlier clock time in the eastern regions of a given time zone than in the western regions, which is thought to induce higher levels of circadian misalignment in the west than in the east (“time zone effect”) [8, 9]. This study evaluated the acute consequences of the DST transition on MVAs in a chronobiological context, quantifying DST, time of day, and time zone effects. We used large US registry data, including 732,835 fatal MVAs recorded across all states (1996–2017), and observed that spring DST significantly increased fatal MVA risk by 6%, which was more pronounced in the morning and in locations further west within a time zone. DST-associated MVA risk increased even in the afternoon hours, despite longer daylight hours. The MVA risk increase waned in the week subsequent to DST, and there were no effects of the fall-back transition to Standard Time (ST) on MVA risk, further supporting the hypothesis that DST-transition-associated, preventable circadian misalignment and sleep deprivation might underlie MVA risk increases.

Just an FYI, the risk comes just from the switch.

I picked two of the most significant papers. Various data analyses have been done, with various models, etc.

Gemini gave me a summary:

I am popping off at various annoyances, but the research itself shows that the spring DST transition itself leads to extra deadly car crashes (about 6% extra), whether early March or a month later (as it used to be).

Once upon a time, we had no DST… and many countries have no DST. It’s not required.

Just saying.

Prior Posts on DST

11 Mar 2024: DST Kills: More Tales of the Killer Time-Changer

2 Nov 2025: The Week in Meep: All Souls Day, Movember, Obra Dinn, Down with DST

5 Nov 2023: Death to Daylight Saving Time!

9 Mar 2025: The Week in Meep: Death to DST (and not us), Sumo (again), The Little Mermaid

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However, one of the biggest differences in mortality patterns (ignoring age) comes from differences by sex, more than geography or race/ethnicity.

Let’s start at the highest level, with the overall top causes of death by count, not distinguishing by age.

Ranking Causes of Death 2018-2024, Count

Top causes of death for females in the U.S.

Top causes of death for males in the U.S.

Some quick observations:

• Heart disease and cancer are #1 and #2 causes of death for both males and females each year. After that, the patterns differ quite a bit.

• COVID has fallen off the top 10 for both sexes in 2024. It fell off for males in 2023 (it was #11 that year), and was #15 for both males and females in 2024.

• Stroke is an important cause of death for both males and females, but has a much higher count for females than males. When we look at rates and age split-outs below, we’ll see what’s going on there.

• A very large difference between the two sexes in the cause of death is “Accidents” as a category. Accidental causes of death are all combined for ranking by the CDC (which I’ve often complained about) — this includes drug overdoses, motor vehicle accident deaths, falls, drowning, and many other causes. Males are far more likely to die in this category. Again, when you look at the age breakout, you will understand better.

• Certain causes always show up in the male top 10 (suicide and liver disease). but not female. There’s not exactly the equivalent on the other side, and this relates to the ages at which people are dying of these causes that are making the top causes. For females, it’s almost all old women. For males, many of these categories have many younger men showing up. We’ll see this in the age breakouts.

Ranking Causes of Death 2018-2024, Age-Adjusted Rate

We’re going to look at these same ranking tables — same ordering for each — but with different numbers for the entries. This is so we can look at the year-over-year changes as well as more direct comparison between the sexes.

Age-adjusted rates are quoted per 100,000 people per year.

More on age-adjusted rates here:

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Top causes of death for females in the U.S.

Top causes of death for males in the U.S.

Again, a few observations:

• For every cause of death that appears on both ranking tables for 2023 and 2024, the age-adjusted death rate decreased between the two years.

• For each cause of death that appears for both sexes in 2024, the rate is lower for females, EXCEPT for Alzheimer’s disease.

• There often isn’t much of a difference in death rate between males and females, except for Accidents, which have a huge difference. We could probably tell that just from the count tables anyway.

• There are some major differences in the rates for natural causes of death, but I’m not going to write about them in this post. Below, I will be looking at ratios between the sexes for specific age groups, and we’ll see that external causes of death (accidents, suicide, homicide) drive the largest gaps in mortality between the sexes.

Ranking Tables for 2024 Causes of Death by Age, U.S., Count

Females

Males

In general, I don’t look at absolute number of deaths for analysis, but I think most people have an easier time thinking about death patterns in this way.

If you look at the top row, which gives the total deaths for each age group (not just from the top ten causes), you will see far more women die at ages 85+ than do men, but it’s not because old women have higher mortality rates (as we’ll soon see). It’s just that women tend to live longer, dying at older ages.

If you look at the causes of death at younger ages (and the numbers), you can see why (and how) the men are dying at younger ages: you see much higher numbers dying of the “nasties” of external causes of death (homicide, suicide, accidents) in young adulthood.

Also, heart disease kills men at much younger ages than women. The cancer numbers aren’t as disparate. You can see heart disease and cancer switching places for males multiple times in middle age into older age for males, while the switchover doesn’t occur for females until the oldest ages.

Ranking Tables for 2024 Causes of Death by Age, U.S., Rate

This time, I’m showing death rates by percentages, as I think most people aren’t used to thinking in rates per 100,000 per year. In addition, I want people to see just how low the rates are for some of these deaths….and just how high some are.

At the top of each table is also a male-to-female ratio for each entire age group’s death rate. Alas, a lot of it is a “fatal stupidity ratio” — to the extent it is reflecting differences stemming from external causes of death.

Females

Males

The main point I want to make here involves some of the changes against 2023:

And one of the great things has been the decrease in external causes of death, primarily for young men.

There was a decrease in 2024 in both homicides and drug overdoses, and the fabulous news is that there was a much larger decrease in 2025 in those causes of death. Both of these had spiked in 2020 and 2021, and it looks like homicide will have dropped to well below pandemic levels, though drug overdose death levels are still a problem.

For other causes of death, such as cancer and heart disease, it seems that pandemic-related increases and/or disruptions may be over … at least at a high level. There may be more detailed issues (such as specific cancer types or at younger ages). We shall see.

I’ll take the good news where I can.

Spreadsheet

Underlying Cause Of Death 2024 Final Stats And Ranking Age And Sex 2026 02 23

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One of the first was to update my organized mortality compilation post here: Mortality Posts and Resources: 2026 Update

If you’re looking for a specific topic, that may be more helpful than using search on substack, as I often write about the same topics multiple times, and substack search is extremely basic.

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Ranking Causes of Death 2018-2024, Count

Counts haven’t changed much from my preliminary ranking table, which is generally what happens. At a high level, there aren’t very many new deaths that come in, and there aren’t many re-categorizations of deaths.

If you’re idly curious, COVID-19 dropped to the 15th place for Underlying Cause of Death in 2024, going down to 31,426 deaths compared to the 50K in 2023.

The causes ranking #11 - #14, ranking above COVID in 2024:

• Flu/pneumonia (48K deaths)

• Kidney disease (42K)

• Parkinson’s disease (41K)

• Septicemia (40K)

We’ll see these in the ranking tables broken out by age group.

Ranking Causes of Death 2018-2024, Age-Adjusted Death Rates

I have to state that this “ranking table” is using the ordering from the number of deaths, because if you look at a cause like suicide, its age-adjusted death rate is higher than causes above it on the list. This relates to the age distribution of deaths for each of these causes, not only the overall rate.

An explanation of age-adjusted death rates is here:

Mortality Basics with Meep: Age-Adjusted Death Rates v. Crude Death Rates for U.S. 1968-2020

The reason to use age-adjusted rates is to be able to compare a trend for a cause of death year-over-year.

For instance, the number of cancer deaths is higher than ever, but the age-adjusted rate continues to decrease.

Ranking Tables for 2024 Causes of Death by Age, U.S., Count

Yes, these are big. There is a lot of information here!

I like to present both count and rate, because one can see that something may be ranked lower for a particular age group, and then see the number of deaths for the older age group is so much higher. It tends to be like that.

Two items can be ranked next to each other, and be very close in count… or very far apart. One sees this with cancer and heart disease deaths for the middle-aged shading into the elderly, as the two causes start out close in number, widen, and then get closer once again as heart disease surpasses.

Ranking Tables for 2024 Causes of Death by Age, U.S., Rate

Rather than use the standard rate per 100,000 used among those of us who throw around mortality rates on the daily, I use percentages. I want to use forms of numbers most people are used to… and it gives people a better idea of the magnitudes.

If you compare the rates I have here against the preliminary rates, you’ll see some differences, because population estimates differed quite a bit for the older age groups. With larger population estimates at the older ages, we end up with lower death rates.

Spreadsheet

Underlying Cause Of Death 2024 Final Stats And Ranking Age 2026 02 19

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Selected Ranking Table Posts

Jan 2025: 2023 U.S. Top Causes of Death by Age Group, Finalized

Jan 2025: 2023 U.S. Top Causes of Death by Sex and Age Group, Finalized

May 2024: 2022 Top Causes of Death in the U.S. by Age Group and Sex, Finalized

Jan 2023: Top Causes of Death, US, 2018-2021

Jan 2023: Top Causes of Death by Age Group, 2021: Finalized U.S. Stats

May 2022: Top Causes of Death for 2021: Heart Disease, Cancer, and COVID

Jan 2022: Top Causes of Death by Age Group, 2020: Death Rates

Jan 2022: Top Causes of Death by Age Group, 2020: Raw Numbers

Apr 2021: Mortality with Meep: Top Causes of Death in the United States in 2020

June 2017: Mortality Monday: Cause of Death, 2014

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21 Jan 2026, NYT: Rahm Emanuel Calls for Age Limit of 75 for President, Congress and Judges

Rahm Emanuel, a prominent Democrat who has signaled his desire to run for president in 2028, on Wednesday called for a mandatory retirement age of 75 for the president, cabinet officials, members of Congress and federal judges.

Mr. Emanuel, a former Chicago mayor and ambassador to Japan, urged the age cap during remarks that were largely focused on education policy at the Center for American Progress, a Democratic think tank in Washington.

‘’Across all three branches of government, 75 years -- you’re out,’‘ Mr. Emanuel said as he laid out a proposal for sweeping ethics changes. ‘’Clean it up, all of Washington, and when you’re 75, you can’t do that in the military, you can’t do it in corporate America, you should not be in government at all. Thank you for your service, up and out.’‘

Mr. Emanuel is rarely seen as part of the top tier of Democrats jockeying to run for the party’s next presidential nomination. But he is one of the most active in trying to guide the party’s direction as it tries to win back power and considers its future.

Mr. Emanuel’s call for an age cap follows the elections of the two oldest presidents in American history. President Trump, 79, has in recent months appeared to fall asleep during Oval Office meetings. His predecessor, former President Joseph R. Biden Jr., was forced to abandon his 2024 re-election campaign at age 81, after Democratic leaders finally acquiesced to the reality that most of America thought he was too old to run again.

Mr. Emanuel is 66, older than many of the Democrats and Republicans who are seen as the next generation of American political leaders. If he were elected president in 2028, his age limit of 75 would in theory prohibit him from serving for a second term.

‘’You can count,’‘ Mr. Emanuel wrote in a text message when asked if the age cap would apply to him, going on to detail his past efforts to enact stricter ethics rules.

This is just an excerpt, but the article doesn’t mention at all that this would require a Constitutional amendment.

So good luck with that.

But, interestingly, Rahm picked 75 in particular, because that age tickled something in my brain… something related to his brother Zeke Emanuel, who wrote something notorious for The Atlantic in 2014, titled: “Why I Hope to Die at 75”

If you’re not familiar with the Emanuel brothers, let me give you a quick rundown:

• Zeke Emanuel: 68 years old, oncologist and “bioethicist”. Yes, I mean the scare quotes. More on him in a moment.

• Rahm Emanuel: 66 years old, Democratic politician, had been in the Clinton, Obama, and Biden administrations. Had a stint as mayor of Chicago, the fool.

• Ari Emanuel: 64 years old, celeb talent agent, best-known as the inspiration for the character Ari Gold on the show Entourage.

Blast from the Past: Dr. Death and Age 75

Let us go back to 2014, and let’s see what age 75, specifically, meant to Dr. Zeke Emanuel. At the time he wrote the article, he was 56 or 57.

But his parents….

October 2014, The Atlantic: Why I Hope to Die at 75

Seventy-five.

That’s how long I want to live: 75 years.

This preference drives my daughters crazy. It drives my brothers crazy. My loving friends think I am crazy. They think that I can’t mean what I say; that I haven’t thought clearly about this, because there is so much in the world to see and do. To convince me of my errors, they enumerate the myriad people I know who are over 75 and doing quite well. They are certain that as I get closer to 75, I will push the desired age back to 80, then 85, maybe even 90.

I am sure of my position. Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value.

But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.

I added that emphasis on the last line.

I want you to understand who wrote this intro: a doctor. A “bioethicist”.

He is/was an oncologist. I’m not sure how many cancer patients he has actually worked with, but I know what it looks like, especially for those who have advanced cancer. I saw the people lined up in wheelchairs in the hallway of Memorial Sloan Kettering in Manhattan, waiting for fluid to be drained from around their lungs.

It’s not pleasant.

All that said, a doctor who thinks it’s okay to off the “feeble”, because non-vibrant life is apparently not worth living. Hmmm.

While obviously I would want a doctor who is attempting the best possible health outcomes for me as a patient… that the doctor evidently has an attitude that a “feeble” life is so pathetic as one should just die already… hmmm. Yeah, I would not want to go to that person as my oncologist. Especially if I had advanced cancer.

Let me be fair — the article wasn’t about rolling over and dying at age 75 itself. It was about not pursuing additional health treatment at that age. But his attitude was way out of date, even in 2014, and perhaps colored by his experience as an oncologist.

People have been living longer and with better health, and no, it’s not because of any “extraordinary” treatments per se.

That said, this is about political mortality and morbidity, but I wanted to point out Dr. Zeke thought 75 was the age at which decrepitude crept in. Oh, feebleness!

In November 2020, Dr. Zeke signed on to Biden’s transition team COVID-19 advisory board.

Biden turned 78 on November 20, 2020.

WSJ: More on the Oldsters in Politics — Push Out Boomers (and Pre-Boomers)

8 Feb 2026, WSJ: Elderly Lawmakers Won’t Step Aside, Prompting New Debate Over Age Limits

An aging political class in Washington is prompting fresh calls for forcing older officeholders to step aside in favor of younger faces.

Working well past retirement age is an area of rare bipartisan agreement in Washington. President Trump will turn 80 this year, and Joe Biden left office at age 82, both breaking Ronald Reagan-era records for age in office. In Congress, Sen. Chuck Grassley (R., Iowa) is 92 years old, while Rep. Maxine Waters (D., Calif.) is 87. It isn’t unusual for members to die on the job, as three did in 2025 alone.

Rahm Emanuel, a 66-year-old Democrat and Washington veteran, recently called for a mandatory retirement age of 75 for presidents, cabinet officials, members of Congress and federal judges. The former congressman, White House chief of staff and Chicago mayor said that should also apply to him, should he ever return to a major Washington job.

“Washington needs a good power washing,” Emanuel, who is exploring a possible 2028 presidential bid, said in an interview.

I put in those emphases.

I’m going to elide over the digs at Trump, because of course, everybody does that in passing when given the chance.

I wrote about those three Congressional deaths last year:

It both was and was not notable, given the ages and causes of death (Ages 70+, mainly cancer, all three male.)

We did have a more recent death, this year, where the 65-year-old Republican Doug LaMalfa died of a heart attack.

I calculated some stats at the time:

Median age:

• Democrats: 57

• Republicans: 58

Mean age:

• Democrats: 58.5

• Republicans: 57.3

Modal age:

• Democrats: 49 (9 reps)

• Republicans: 55 (10 reps)

The WSJ has its own graphs:

They also have a graph of age at inauguration for Presidents. Let me do something with that.

Misleading graphs: Age at Inauguration for Presidents

Yes, we know how old they were when we elected them. Or sworn in, as with LBJ.

I noticed they started with JFK.

Why? Come on, we know why.

Let me include ALL the presidents.

I’ll make it more useful, in that I’ll put in dates of inauguration, and not the people’s names, so maybe you can see a pattern….

Maybe you can see why Eisenhower (62 years old) and Truman (60 years old) were omitted from the “modern-era” presidents graph. That would have thrown off any concept of a “trend”.

In general, throughout U.S. history, the men who made it to the presidency were in their 50s. That was the peak of most men’s careers.

It’s only been a couple of old guys who have slipped through the last couple of terms. Even Trump was only just over 70 1/2 (no longer the required minimum distribution age) in 2017.

You might be interested in this next graph:

(Yes, there is only one dot for Grover Cleveland in here, and I used only his first inauguration for this one).

I could do how long past leaving office the presidents survived, but we know that is 0 for 8 of the presidents (4 assassinations, 4 natural deaths), which would have certain effects on a regression line. We can still see the effects of the 8 deaths in office, but with FDR’s long reign, he lasted longer than some men who had one term and dropped dead soon after being voted out.

You can see Jimmy Carter floating high above the rest, having the longest post-presidency ever.

But you can see there is a very weak correlation here, as it’s all a blob. Some of the younger guys had tragically young deaths, and some of the older guys were from the “modern era”, and lived long….

…but then, one of our longest-lived Presidents was John Adams, who died at almost the age of 91. He’s the 5th-longest-lived president, coming in after only the “modern” presidents of Jimmy Carter (100), George HW Bush (94), Gerald Ford (93.5), and Ronald Reagan (93.3).

The only thing I have to say about potential age limits for federal judges, Congresspeople, and the President is that it would take an amendment to the U.S. Constitution. Perhaps people are ready to do that.

Or maybe they could just not vote for superannuated politicians. It’s a choice.

For judges, it’s more of a bind — maybe people are fed up with that situation. It still would likely take an amendment, not merely legislation. I don’t see that addressed in the piece. Of course, Congress could start impeaching judges for incompetence (if they are senile). That’s also a choice.

Spreadsheet

Presidential Ages And Inaugurations 2026

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Related Posts

• Jan 2026: Congressional Mortality 2026 Update: More Consequences

• 16 Oct 2025: Falls are Dangerous: RIP, Ace Frehley and Watch Out, Sen. McConnell

• 5 Sep 2025: Political Candidate Deaths: Seven German AfD politicians die within weeks of each other ahead of elections

• 25 May 2025: Political Mortality Update: Yes, A THIRD Democratic Representative Died in 2025

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• Jan 2024: Trump v. Biden Take Two - Using Social Security Mortality Assumptions

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It was.

9 Feb 2026, People: Catherine O’Hara’s Cause of Death Confirmed, Comedy Legend Privately Faced Rectal Cancer: Medical Examiner

Catherine O’Hara‘s official cause of death has been determined.

The actress, known for her roles in Schitt’s Creek and Home Alone, died at 71 on Friday, Jan. 30. Her rep confirmed to PEOPLE at the time that she’d died “after a brief illness” but did not provide further details.

On Monday, Feb. 9, the Los Angeles County Medical Examiner’s Office confirmed that O’Hara died after suffering from a pulmonary embolism, according to a death certificate obtained by PEOPLE. Rectal cancer was listed as the underlying cause of the embolism.

According to this article: 9 Feb 2026, sfgate: Catherine O’Hara died from a pulmonary embolism. Cancer was the underlying cause

A Los Angeles County death certificate issued Monday lists the pulmonary embolism, which occurs when a blood clot blocks an artery in the lungs, as the immediate cause of the actor's Jan. 30 death at age 71. Rectal cancer was the long-term cause.

The oncologist who signed off on the certificate indicated that he had been treating O'Hara since March of last year, and last saw her on Jan. 27. She died at a hospital in Santa Monica, California.

Pulmonary embolisms are essentially blood clots in your lungs.

My late husband Stuart probably died due to pulmonary embolism, caused by his prostate cancer. Blood clots had been proliferating through his body, and they had imaged several clots in his lungs. He was regularly administering injectable anticoagulants for the last month of his life. But it could do only so much — the cancer was winning at that point.

Some Medical Information on Cancer and Pulmonary Embolisms

Pulmonary embolisms are more common with some types and some stages of cancer.

University of Texas, MD Anderson Cancer Center: Cancer and Pulmonary Embolism Development

A pulmonary embolism (PE) is a blood clot (or thrombus) that travels from the leg, pelvis or arm into the pulmonary artery and blocks blood delivery to the lungs. Among non-hospitalized cancer patients being treated with chemotherapy, approximately 3% of deaths are caused by PE. Among hospitalized cancer patients, up to 10% of deaths are caused by PE.

Pulmonary embolism causes

A pulmonary embolism usually starts as a blood clot in the leg or pelvis, where the clot is called a deep vein thrombosis (DVT). If a piece of the clot breaks off from the vein and travels (embolizes), through the circulatory system to the pulmonary artery, it can block the supply of blood to the lungs. At that point, it is called a pulmonary embolism.

There are many things that lead to the formation of a deep vein thrombosis/pulmonary embolism in cancer patients. Some types of cancer are more likely to cause these clots, including:

• acute leukemia

• brain cancer

• breast cancer

• colorectal cancer

• gynecological cancers

• kidney cancer

• lung cancer

• melanoma

• pancreatic cancer

The risk of clotting increases as the cancer grows and spreads in the body.

We didn’t see the clots for Stu until near the end.

28 May 2025, Journal of Clinical Oncology: Pulmonary embolism in cancer patients: Clinical insights and outcomes from a community hospital.

Abstract: [I added some emphasis]

Background: Pulmonary embolism (PE) is a leading cause of death in cancer patients, driven by hypercoagulability, immobility, and cancer therapies. Cancer increases the risk of venous thromboembolism (VTE) by up to 7-fold, with certain malignancies, such as gastrointestinal, pancreatic, and lung cancers, carrying the highest risk. PE in cancer patients often presents atypically, with a high rate of incidental diagnoses and significant mortality and bleeding risks. This study evaluates the clinical presentation, characteristics and outcomes of PE in cancer versus non-cancer patients in a community hospital setting.

Methods: A single centre retrospective cohort study was conducted on patients diagnosed with PE from 2018 to 2023 at a community hospital in Northern Illinois. Patient demographics, clinical presentation, PE characteristics, and outcomes were compared between cancer and non-cancer groups. Cancer-specific mortality at 30 days and 1 year was analyzed. Statistical analyses included chi-square and t-tests.

Results: Among 301 patients, 69 (22.9%) had active cancer, with lung (24%), gastrointestinal (18%), and breast (14%) cancers being the most common. Cancer patients were older (68 vs. 60 years), predominantly female (57% vs. 48%), and more likely to smoke (50.7% vs. 39.2%). Shortness of breath was the main presenting symptom in both groups, but cancer patients were more likely to have incidental PE (14.4% vs. 8.1%, p = 0.18) and syncope (11.5% vs. 6%, p = 0.1), and less likely to report chest pain (5.7% vs. 14.6%, p = 0.08), though none of these differences were statistically significant. Right heart strain (20.2% vs. 32%, p = 0.08) and saddle PE (1% vs. 5%, p = 0.3) were less common in cancer patients. Bleeding complications were significantly higher in cancer patients (15.9% vs. 6.8%, p = 0.02) along with in-hospital mortality (17.3% vs. 7.3%, p = 0.02), though many deaths were associated with advanced cancer or sepsis rather than PE itself. ICU admissions (33% vs. 34.4%) and recurrent VTE (4% vs. 3.8%) were similar. Hospice involvement occurred in 10% of cancer patients, mostly after intubation and prolonged hospital stays. Thirty-day mortality in cancer patients was 14.5%, primarily driven by sepsis secondary to pneumonia and urine infections. No deaths were linked to recurrent PE or bleeding. One-year mortality was 4.3% and included bleeding, recurrent PE, and cancer-related death.

Conclusions: Cancer-associated PE increases in-hospital mortality, yet early recognition and treatment can result in stable long-term outcomes, especially in early stages of cancer. Select patients in ICU might benefit from early palliative intervention. Bleeding risk should be proactively managed throughout the hospital stay and during recovery. Close follow up with oncology or primary care post-discharge is essential to monitor and prevent post-hospitalization complications.

I do see that this particular case study is retrospective, and there are issues with interpretation given that situation.

What might be useful, though, is to look at a bit of history.

Armand Trousseau — A Man Who Came Up With a Diagnosis For His Own Cause of Death

Armand Trousseau was a French internist, born in 1801 and active in French politics after the revolution(s) of 1848. It was an active time in the development of medicine — Trousseau became known for the quip, “Use new drugs quickly, while they still work.” (… though, I assume, in some version in French. I cannot find the original.)

One of the many medical observations he became known for was the Trousseau sign of malignancy:

The Trousseau sign of malignancy or Trousseau's syndrome is a medical sign involving episodes of vessel inflammation due to blood clot (thrombophlebitis) which are recurrent or appearing in different locations over time (thrombophlebitis migrans or migratory thrombophlebitis). The location of the clot is tender and the clot can be felt as a nodule under the skin.^[1] Trousseau's syndrome is a rare variant of venous thrombosis that is characterized by recurrent, migratory thrombosis in superficial veins and in uncommon sites, such as the chest wall and arms. This syndrome is particularly associated with pancreatic, gastric and lung cancer and Trousseau's syndrome can be an early sign of cancer^[2][3] sometimes appearing months to years before the tumor would be otherwise detected.^[4]

Obviously, given the time, there were no noninvasive ways to discover cancerous tumors. In fact, many times, many cancerous tumors were found after death.

Looking at Trousseau’s history of items attributed to him, he must have been an observant man who kept very good records.

Armand Trousseau first described this finding in the 1860s; he later found the same sign in himself, was subsequently diagnosed with gastric cancer and died soon thereafter.^[6] Trousseau presciently attributed thromboembolism in malignancy to changes in blood composition rather than local inflammatory or mechanical forces. By correlating clinical observation with surgical and autopsy findings, Trousseau recognized that a localized cancer could induce a generalized hypercoagulable state in which thrombosis could occur elsewhere in the body, such as in extremities with visceral malignancy.

I want to say something in passing.

“Gastric cancer,” aka stomach cancer, is one of those conditions I noticed as occurring quite often among notable 19th-century men. James Clerk Maxwell, the famous physicist, died from stomach cancer at the age of 48 in 1879 (his mother had died at age 48 as well… from the same cancer.)

Armand Trousseau Diagnoses His Own Cancer

Let me get away from Wikipedia and use some different sources:

2019 Jan 31, Cancer: The History of Armand Trousseau and Cancer-Associated Thrombosis

“Je suis perdu; une phlegmatia qui vient de se déclarer cette nuit, ne me laisse aucun doute sur nature de mon mal.”

—Armand Trousseau [1]

“I am lost; a phlebitis which has declared itself this night leaves me no doubt about the nature of my illness.”

The above is what Armand Trousseau said to a colleague (and the translation into English) when he realized that the signs he saw in his own limbs meant he had cancer. He had been lecturing to crowds about his observations… and he saw the very symptoms that he had been describing to others.

In the chapter entitled “Phlegmatia Alba Dolens”, originally published in French in 1865 [7], from his most famous work, the compilation of his delivered lectures, Clinique Medicale de l’Hotel-Dieu de Paris, Trousseau discussed several detailed cases and put forth the symptom of migratory thrombophlebitis as a valuable diagnostic element of visceral cancer.

“I have long been struck with the frequency with which cancerous patients are affected with painful oedema in the superior or inferior extremities, whether one or other was the seat of cancer. This frequent concurrence of phlegmasia alba dolens with an appreciable cancerous tumor led me to the inquiry whether a relationship of cause and effect did not exist between the two, and whether the phlegmasia was not the consequence of the cancerous cachexia. I have since that period had an opportunity of observing other cases of painful oedema, in which, at the autopsy, I found visceral cancer, but in which during life, there was no appreciable cancerous tumor; and in which there existed a cachexia referable neither to the tubercular diathesis, the puerperal state, nor chlorosis. I have thus been led to the conclusion that when there is a cachectic state not attributable to the tuberculous diathesis nor to the puerperal state, there is most probably a cancerous tumor in some organ.” [8].

He also astutely observed, quite ahead of his time, that a “particular condition” in the blood, speculated to be “excess of fibrin, and an increase of white globules”, was the primary cause of thrombosis and that the change (hypercoagulable state) was also evident in many other disorders [8]. Although the first case of blood clot in cancer was noted by Jean-Baptiste Bouillaud in a publication several decades earlier [9], Bouillaud’s contribution to the field was limited, since he preferred the studies of cardiology and neurology [10]. Nevertheless, the keen observation of Bouillaud was acknowledged by Trousseau in his seminal lecture to be the basis of all venous obstruction research made in France since 1823 [8].

Trousseau retired from his prestigious post at the Faculty of Medicine and the Hôtel-Dieu de Paris (the oldest hospital in Paris) in the summer of 1866. He was tired and suffering from ill health and, as months progressed, he began to analyse his symptoms; weight loss, lack of appetite, repeated haemorrhages and stomach pains that were becoming increasingly resistant to opium [1]. For a while, he found no palpable tumour and, most importantly, no painful inflammation or oedema along the venous paths. But once he detected the missing sign he had searched for in so many of his patients, his diagnosis of gastric cancer was confirmed, and he lived for several more months in agony for its discovery, for he knew better than anyone the fatal outcome of his illness (Figure 1).

Back to Catherine

That was a little of a historical jaunt, and alas, in doing some background research I found some other links (which I will not link) that Trousseau’s signs can still be relevant for undiagnosed cancer.

But that’s enough cancer.

Let’s have some Catherine O’Hara.

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There are different aspects of different types of cancer. As we have learned over the years, some cancers have a close link to viruses, as with HPV and cervical cancer, for instance. Some cancers, like lung cancer, have had such a high link with smoking that the non-smoking drivers have been more difficult to see until far fewer people were smoking. Then people noticed odd cancer clusters related to radon.

Cancer and heart disease have been the top two causes of death in the U.S. for decades, and due to more rapid improvements in heart disease treatment (and other trends) compared to cancer, people thought that cancer would exceed heart disease as the cause of death at some point…

…but this hasn’t happened yet.

Report: Increased Cancer Incidence and Mortality at Younger Ages

31 Jan 2026, Yahoo Health: Why are so many younger Americans getting and dying of colorectal cancer?

Colorectal cancer was once viewed as being mostly diagnosed among middle-age and older adults, but that’s changing.

Research shows more adults in their 20s, 30s and 40s are being diagnosed with colorectal cancer, with incidence increasing over the last three decades.

Deaths are on the rise too, with a recent study finding colorectal cancer is now the leading cause of cancer-related deaths in men -- and second in women, under age 50.

I’ve pointed this out in older posts. This has been a long-term trend, going back decades.

The above news story is coming from this American Cancer Society press release:

22 Jan 2026, Mortality Under 50 Declines for 4 of 5 Leading Cancers in U.S., but Colorectal Now Top Cancer Killer, New ACS Study Finds

A new study by American Cancer Society (ACS) researchers shows that overall cancer mortality in people younger than 50 in the United States has decreased by 44%, from 25.5 per 100,000 people in 1990 to 14.2 in 2023. The progress is due to declines in mortality for four of the five leading cancer-related deaths (breast, lung, and brain cancers, and leukemia). Only colorectal cancer (CRC) mortality increased, by 1.1% per year since 2005, advancing it from the fifth most common cancer death in the early 1990s to first in 2023. The study is to be published today in the Journal of the American Medical Association (JAMA).

“The steady rise in colorectal deaths under 50 is even more alarming compared to the dramatic declines for lung and breast, even as breast cancer incidence is climbing,” said Rebecca Siegel, MPH, senior scientific director, surveillance research at the American Cancer Society and lead author of the report. “While we await answers for why colorectal cancer rates are up, lives can be saved now through symptom awareness and destigmatization, and more screening uptake, as three in four people under 50 are diagnosed with advanced disease.”

For the study, scientists analyzed trends in the annual numbers of cancer deaths and age-standardized rates per 100,000 men and women aged 0-49 years for the top 5 cancer-related deaths during 1990-2023 in the U.S. They used data from the National Center for Health Statistics as provided by the Surveillance, Epidemiology, and End Results (SEER) program at the National Cancer Institute.

The results showed that 1,267,520 people died from cancer in the U.S. before age 50 from 1990 through 2023, and the overall death rate decreased by 44%. Four of the five leading causes of cancer death decreased, with the average annual decline during 2014-2023 ranging from 0.3% for brain cancer and 1.4% for breast cancer to 2.3% for leukemia and 5.7% for lung cancer. Only CRC mortality increased annually for people under 50. Lung cancer and leukemia dropped from ranking first to fourth and third to fifth, respectively, whereas breast cancer remained the second leading cancer death overall and first in women. Cervical cancer ranked third in women in 1990 and 2023, despite a continuous decline throughout the study period. The cancer distribution in men mirrored the overall pattern, with breast cancer replaced by non-Hodgkin lymphoma (4^th) in 1990 and pancreatic cancer (5^th) in 2023.

“We weren’t expecting colorectal cancer to rise to this level so quickly, but now it is clear that this can no longer be called an old person’s disease. We must double down on research to pinpoint what is driving this tsunami of cancer in generations born since 1950,” added Dr. Ahmedin Jemal, senior vice president, surveillance, prevention, and health services research at the American Cancer Society and senior author of the study. “In the meantime, people 45-49 years make up fifty percent of diagnoses under 50, so increased screening uptake will prevent disease as well as death.”

“The progress in overall cancer mortality in people under 50 is encouraging and demonstrates that increased access to prevention and screening services is making a real difference in the fight against cancer,” said Lisa A. Lacasse, president of the American Cancer Society Cancer Action Network(ACS CAN), the advocacy affiliate of the American Cancer Society. “This research underscores the urgent need to protect and expand access to care, especially at a time when increasing health care premiums and cuts to prevention and screening programs threaten to reverse our progress and undo the gains we have achieved. We cannot afford to turn back the clock now. ACS CAN will continue to work with lawmakers to advocate for policies that will move us forward in our mission to end cancer as we know it, for everyone.”

This is the mix of good and bad news and reflects what I showed in older posts (I will drop related links at the bottom of this post).

This is not new news.

Back Up Two Years: Princess Catherine Announces Cancer Diagnosis

In March 2024, Catherine, Princess of Wales, announced she had been diagnosed with cancer. (King Charles was also diagnosed with cancer, but we’re focusing on the higher incidence of cancer for younger adults.)

She had a message for World Cancer Day this year.

4 Feb 2026: Kate Middleton Recalls ‘Moments of Fear’ as She Reflects in New Message on World Cancer Day

Kate Middleton released a new message to commemorate World Cancer Day.

World Cancer Day is observed annually on Feb. 4, and the Princess of Wales, 44, released a new video to social media about the occasion.

The short clip featured footage of Princess Kate meeting people during her visit to The Royal Marsden Hospital’s Chelsea site in January 2025. The outing came with the confirmation that she received treatment from The Royal Marsden during her cancer journey, and the Princess of Wales shared later that day that she was in remission.

In a voiceover of the new video shared to Instagram, Princess Kate began, “On World Cancer Day, my thoughts are with everyone who is facing a cancer diagnosis, undergoing treatment or finding their way through recovery. Cancer touches so many lives — not only patients, but the families and friends and caregivers who walk beside them.”

Back in 2024, this is what I posted:

And in that post, I pulled out there had been an increasing incidence of cancer for younger adults:

Concerning increase in fatal cancers in young adults

Let us return to my colorectal cancer post from a few days ago:

Colorectal Cancer: Top Cancer With Concerning Trend in Younger Ages

Mary Pat Campbell

·

March 20, 2024

Read full story

There is more at the post.

But that’s not the only cancer with concerning trends at young ages, especially in 2023.

Mind you, cancer deaths in young adults (age 15-44) are very low compared to the middle-aged and seniors.

But in general, cancer death rates for most cancers have been decreasing for those groups, so when I see persistent increases in deaths, and I see research/clinical reports on increased diagnoses of certain cancers at advanced stages in young adults, I pay attention. The report on early-onset colorectal cancer is one such.

More cancers with increased incidence in young adult deaths

I have been investigating a variety of cancer types that seem to be involved with deaths for young adults in the U.S. in 2023 in particular.

Note: cancer deaths for young adults overall don’t seem elevated:

But that’s before you disaggregate for cancer type:

[UPDATE: ADDED LABEL TO TABLE]

I will need to return to these.

Some of the cancers seem to be increasing in mortality rate for young adults since the pandemic and some, such as colorectal cancer, have had decades-long increasing trends.

We don’t know why.

The Good and the Bad News

The good news, because I don’t want to run the bad news into the ground, is that survival rates have improved greatly for those with cancer diagnoses, at all stages — yes, including “terminal” cancer.

“Advanced” cancers are those that are spread throughout the body at time of diagnosis. Alas, many types of cancers have been found at advanced stages, partly because we don’t have many (or any) ways to screen for them…until they become so bad they can’t be ignored.

That said, death rates due to cancer have a very good trend:

…But since the pandemic, it has somewhat stalled.

But mainly at the oldest ages.

So while there are increases of colorectal cancer incidence (and death) at younger ages, other cancers have been improving in rates in terms of incidence and mortality rates for younger adults. Some of this is related to smoking rate reduction as well as screening to catch cancers at earlier stages, at which point some cancers are curable.

It’s a mix.

Related links with Images, 2024-2025

5 Oct 2024: Notable Cancer Deaths: Cancer is the Top Cause of Death in Middle Age

8 Feb 2024: Top Cancer Types: By Crude Death Rate, 1968-2023

10 Feb 2024: Cancer Death Rates by Age and Gender for the U.S., 1968-2023

20 March 2024: Colorectal Cancer: Top Cancer With Concerning Trend in Younger Ages

2 Apr 2024: Cancer Trends among Young Adults: An Issue of Rates and Types

18 Aug 2025: The Changing, Extended Life with Terminal Cancer

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Here is the PDF of same: Data Brief, Mortality in the United States, 2024

The people who work at the CDC get first stab at the mortality statistics (only fair, they clean up the data that comes in, put up with annoying questions from people like me, yadda yadda), so I don’t see the data available at WONDER yet for the kind of breakdowns I prefer.

So I will take some highlights, explaining some of the concepts to provide context.

As the comparisons being made tend to be against only 2023, as I have prior years’ data, I will use the new data points in my old, longer-term data sets to show the long-term trend.

Period Life Expectancy Continues To Increase, Recovering from Pandemic Disruption

Here we go with their graph:

I do have prior years’ data, so let me give you a longer-period graphical representation:

U.S. Period Life Expectancy by Sex, 2015-2024

It may not be obvious peering at the graphs, so let me give you little tables, as I did with the last such update:

Life expectancy now exceeds the pre-pandemic level in 2019, for both sexes, which was not the case in 2023.

Last year’s post:

Yay!

To be sure, period life expectancy is a high-level metric that collapses a large amount of information into one number. There are some bad mortality trends (as I have some posts brewing in the background), but the high-level story is that the big impacts of the pandemic are gone.

Smaller impacts may remain… and there may be long-term morbidity (that is, illness, rather than death).

Longer-Term Life Expectancy Trend: 1900-2024

It can help to see the mortality impact of the recent pandemic, at a high level, by looking at longer-term life expectancy graphs.

The older mortality tables come courtesy historical information from the Social Security Administration. Downloadable spreadsheet, with links to the sources, is below.

Male

That is quite the dip in life expectancy in 1918 (the Spanish flu pandemic…. note the effect is from birth, not at age 65.)

Female

There are different gaps between the life expectancy from birth for males and females, which relates to the probability of dying before age 65 (and exactly the distribution of ages at which one dies so young.)

But again, you need to remember these are period life expectancies and not cohort life expectancies — that is, this has nothing to do with what you, as an individual, living in the year 2026, has as your personal life expectancy.

The period life expectancy from birth and age 65 as reported above is just one mortality metric so that one can compare one year against another as to general mortality levels.

Information on period vs. cohort life expectancy

From my prior post:

Period life expectancy is the life expectancy you hear reported each year in the press, that gets released by the CDC in these reports, etc.

It is taking the mortality experience for the whole population during a specific time period, usually a single year (in this case, 2021), and then calculating life expectancy as if the mortality seen by the full population during that year was the one a person would be seeing during a lifetime. No person actually lives through a mortality pattern like this, because we’re not in a “steady state” for mortality.

Period life expectancy is the flip-side of age-adjusted mortality rates.

Cohort life expectancy is the life expectancy based on one’s birth year, which is the relevant life expectancy for things such as retirement planning. As an actuary, I’m looking at this measure for pensions and annuities. Well, no, I’m not.

In the next few sections, the CDC report uses the age-adjusted death rate, which is my preferred mortality metric for comparisons. Or perhaps just the plain death rate for an age group.

I can explain why you don’t use cohort life expectancy for retirement planning here:

Spreadsheet

Us Period Life Expectancy 1900 2024 As Of 2026 01 31

3.97MB ∙ XLSX file

Download

Download

Excellent News: Decrease In Death Rates Across the Board… Especially the Young

There is excellent news across the board for the 2024 data, in that not only did mortality drop … it’s the why and who.

There are classification issues re: race/ethnicity, evidently, so I’m not dealing with that right now. I have to look into that later.

Less controversial is age, and here is their graph:

Death rates are quoted in rates per 100,000 people, so the death rate for those age 75-84 years old, for instance, is about 4.3% per year.

Let me show you this as a table - as percentage change in rate from 2023 to 2024:

Young adults and teens have seen their death rates drop, thank goodness — those had increased due to the “nasties”: suicide, homicide, drug ODs… and even motor vehicle accidents.

Speaking of which…

Causes of Death

I want to highlight “unintentional injuries”, aka “Accidents”.

A lot of nasty stuff gets hidden in that cause of death. Drug overdoses. Motor vehicle accidents. Falls (seniors, mostly). Drowning. Lightning strikes (not many people die that way, but still.)

The main huge increase in cause of death in that category during the pandemic was drug ODs, most often from fentanyl. There was a decrease in that cause in 2024, and it continued to decrease into 2025. A lot.

Of all the causes of death above, including suicide, they decreased in age-adjusted rate by about 2-4% compared to 2023.

Except for “accidents” — those decreased in rate by 14%.

This is fabulous news.

Once the finalized data set is released, I will be digging into these nasties, but also the top causes of death in general.

We’ll see how these compare. I expect the rates to differ a little, but sometimes even the counts shift a bit due to recalcitrant states needing to have their data cleaned up a lot.

Related post:

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I will be coming back to that in a moment. (I avoid the Taconic as much as possible, and you will see why below)

Weather Woes to Come

My favorite account to follow on Facebook for my weather forecasting needs is Hudson Valley Weather, which mirrors the forecasts on their website: HudsonValleyWeather.com.

I’m in the area that is likely to be hit with substantial amounts of snow this weekend, no matter which forecast model you choose:

My southern family and friends, however, are likely to be hit with ice and/or sleet, though some places are resorting to some odd comparisons:

Oooookay. This is why I prefer deciduous trees over conifers, no matter how catchy a song TMBG sings about them. Alas, I have a few in my yard, and I hope the snow will fall off without my help.

Snow Shoveling: The Cardiac Menace

Especially for men.

I ran this at the end of December, and I’m running it again:

Here is the nut:

• Cold weather constricts arteries (including cardiac arteries)

• Some people (especially middle-aged men) have cardiac artery blockage they don’t know about

• …but they will become aware of that blockage if they shovel snow!

The two key links:

12 Dec 2025: Arctic plunge to bring sub-zero temps and snow; take extra care to stay heart healthy

Rosen says someone who’s not as active during the year and then picks up a snow shovel in the winter may not realize the extreme cold and exertion forces your heart to work harder, sometimes dangerously harder.

• Shoveling is primarily arm work, which is harder on the heart than leg work.

• Lifting heavy loads often causes people to hold their breath without realizing it, spiking heart rate and blood pressure.

• Cold air constricts blood vessels throughout the body, raising blood pressure and tightening coronary arteries.

The risk is even greater for people with cardiovascular concerns such as a sedentary lifestyle, obesity, smoking history, diabetes, high cholesterol, high blood pressure, or a prior heart attack, stroke or other cardiac condition. Talk to your doctor about any limitations on your winter activities based on your heart health.

2020 March, Circulation: Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update: A Scientific Statement From the American Heart Association

Snow shoveling has repeatedly been associated with increased cardiovascular events soon after major snowstorms,^105–107 probably because it can elicit higher rate-pressure products than maximal treadmill testing¹⁰⁸ and is often performed by unfit individuals with known or occult CAD. Also, some cardiac patients develop angina at lower rate-pressure products during exercise in cold temperatures,¹⁰⁹ possibly because of cold-induced vasospasm. Ventricular arrhythmias, coronary plaque rupture and ST-segment–elevation MI,¹¹⁰ and subacute stent thrombosis¹¹¹ have also been reported with snow shoveling.

It’s not just snow-shoveling, but any exertion in cold temperatures.

As I said last time: pay somebody else to do it!

Dangerous Roads

I live near one of the deadliest roads around (#7 on this list):

I avoid the Taconic as much as I can. I hate it. It’s narrow, windy (as in it winds back and forth), there are often wrong-way accidents due to weird intersections for how people enter the highway, and the road conditions really suck when the weather is bad.

I assume most of us in the path of the storm are staying off the roads while the “weather” is coming down, RIGHT?

But there are always a few who push their luck.

Note to Yankees who moved south: YOU CANNOT DRIVE ON ICE.

Also, no, the southern states do not have the salt and other road prep that New York and similar states have. Your 4WD will not let you drive on the unprepared roads of Tennessee.

STAY OFF THE ROADS while they’re still sloppy.

Cold Kills

Finally, just re-running portions of this:

But that’s about deaths due to heat! you cry…. nope, I put in deaths due to cold for comparison, and I won’t have the information for 2025 until mid-2026, due to the delay in reporting “external causes of death”.

So here are the graphs from the post so you can see what the deaths due to cold look like:

The elderly are most susceptible to death due to natural cold. Please check on your grandparents (or parents… or yourself! As the case may be….)

Cold kills far faster than heat, and even with many of the elderly moving to warmer states, we still see the rate being much higher for the elderly. This winter storm is not just about ice/sleet/snow, but also very low temperatures and wind chill.

Stay warm and toasty! If you have to, due to power outages, bundle up and snuggle with family (if you can).

(And be careful about lighting any fires….)

Everybody, stay safe out there!

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Let me explain this graph, because some may misinterpret: this is not the number of fentanyl OD deaths per month in the U.S., but a rolling-12-month count, ending with the count in August 2025.

So the 21,000 death decrease is comparing the peak of 111K opioid OD deaths over July 2022 - June 2023 to the 69K deaths of September 2024 - August 2025.

The 69K deaths bring us back to a pre-pandemic count, last seen in October 2019. Again, to keep this post simple, I’m only doing death counts and not rates.

Various explanations

8 Jan 2026, Science: Did the illicit fentanyl trade experience a supply shock?

Abstract

Fatal overdoses from synthetic opioids, most notably fentanyl, steadily increased more than 25-fold in the United States over 15 years, peaking at 76,000 in 2023 (1). This trend began to sharply reverse in mid-2023, dropping the annual rate of fentanyl overdose deaths (ODDs) by over a third by the end of 2024 (1). Explaining this unexpected drop is of major scientific and policy interest. Whether a supply shock could account for a substantial part of the decline is challenging to determine because drug trafficking organizations operate in secret. Synthesizing data from the US and Canadian governments and from discussions on the social media platform Reddit, we suggest there was a major disruption in the illicit fentanyl trade, possibly tied to Chinese government actions, that translated into sharp reductions in overdose mortality beginning in mid- or late-2023 and continued into 2024 across both the US and Canada.

The footnote has a stale link to a CDC press release, which I found:

25 Feb 2025, CDC Press Release: CDC Reports Nearly 24% Decline in U.S. Drug Overdose Deaths

“It is unprecedented to see predicted overdose deaths drop by more than 27,000 over a single year,” said Allison Arwady, MD, MPH, Director of CDC’s National Center for Injury Prevention and Control. “That’s more than 70 lives saved every day. CDC’s public health investments, our improved data and laboratory systems for overdose response, and our partnerships with public safety colleagues in every state mean that we are more rapidly identifying emerging drug threats and supporting public health prevention and response activities in communities across America.”

While this national decline is encouraging news, overdose remains the leading cause of death for Americans aged 18-44, highlighting the importance of sustained efforts to ensure this progress continues. President Trump first declared opioid overdose to be a public health emergency in 2017, a designation that remains in place, and the subsequent public health investments to CDC from Congress have transformed the nation’s ability to use data to save lives. In the most recent data, 45 states showed declines in overdose deaths, but five states—Alaska, Montana, Nevada, South Dakota, and Utah—still saw increases in overdose deaths, highlighting the continued need for rapid local data and tailored response. In addition to the large provisional drop in fatal overdoses, we also see smaller decreases in nonfatal overdoses, as measured by emergency department visits for overdose, and welcome continued decreases in self-reported youth substance use.

Multiple factors contribute to the drop in overdose deaths, including widespread, data-driven distribution of naloxone, which is a life-saving medication that can reverse an overdose; better access to evidence-based treatment for substance use disorders; shifts in the illegal drug supply; a resumption of prevention and response after pandemic-related disruptions; and continued investments in prevention and response programs like CDC’s flagship Overdose Data to Action (OD2A) program.

A drop in the supply seems more credible than Narcan availability, given the huge drops in deaths.

Sorry, y’all, but what has often happened was that people were saved from their current OD event by Narcan… but would only have a fatal OD later. The bigger thing that saved them was just not having the fentanyl to kill them.

10 Jan 2026, Forbes, Jesse Pines: Lower U.S. Fentanyl Deaths Linked To China’s Policies, Study Says

What caused this dramatic change? A landmark study published this week in Science offers a compelling explanation. The evidence suggests the decline was not primarily driven by U.S. domestic policy. Instead, a major disruption in the global fentanyl supply chain appears to have played a substantial role, most likely originating with controls on precursor chemicals in China.

Why Treatment and Enforcement Can’t Explain the Drop In Fentanyl Deaths

When overdose deaths fell, some credited domestic policy interventions such as expanded naloxone access to reverse overdoses, medication-assisted treatment to bridge people off the addictive drugs and intensified law enforcement. Yet the timing and scale of the decline do not align with these domestic policy interventions.

The sharp drop beginning in mid-2023 occurred almost simultaneously in both the United States and Canada. This synchrony points to a shared, upstream effect, likely a shock to the drug supply from policies enacted in China. If U.S. border security or domestic enforcement were the primary drivers, Canada’s trend line would likely have remained largely unaffected. It did not.

Contemporaneous reporting from the U.S. Drug Enforcement Administration (DEA) also emphasized difficulties obtaining key precursor chemicals rather than claiming enforcement victories, further supporting a supply-side explanation.

….

When access to fentanyl became constrained, the shrinkage appeared in reduced purity. In fact, the average purity of seized fentanyl powder fell sharply from a peak of roughly 25% in mid-2023 to about 11% by the end of 2024. Fentanyl pills showed a similar, slightly delayed decline in potency.

Shrinkflation is a well-established economic indicator of supply shortages. Lower average purity reduces the chance of overdose risk at the population level, even as individual risk remains high due to unpredictable variability in street drugs.

….

Additional insight comes from an unconventional but increasingly valuable source: social media. Researchers analyzing discussions on drug-related Reddit forums found that mentions of fentanyl “droughts” and shortages spiked in mid-2023 and surged again later that year. Users reported that “fetty” (i.e. fentanyl) was harder to find and weaker than before. While not traditional surveillance data, these unfiltered signals closely tracked laboratory purity data, seizure trends and declining overdose deaths.

….

This timing coincides with stepped-up Chinese regulatory and enforcement actions in late 2023 and throughout 2024, following renewed diplomatic engagement between the U.S. and China. Chinese authorities reported shutting down online chemical marketplaces and removing tens of thousands of advertisements related to precursor sales.

Now, again, while they may credit foreign policy in engaging with China… I have been wondering whether China was having issues internally with fentanyl. They’ve already shown problems in controlling other things inside their own borders that perhaps was intended for foreign consumption only (as it were).

There was something noted as awry in the Science article:

8 Jan 2026, Washington Post, David Ovalle and Cate Cadell: A study offers a surprising reason for plunging U.S. overdose deaths

China agreed to internal restrictions on fentanyl-related substances during the first Trump administration. But that led to Mexican criminal groups synthesizing illicit fentanyl in secret labs in Mexico with precursor chemicals bought from companies in China. Since 2023, the Chinese government has shut down some of those companies as part of a broader crackdown.

….

The Science researchers caution that the precise scope of China’s crackdown is difficult to assess, given the opacity of enforcement in the country. China’s cooperation with U.S. drug authorities on fentanyl has long been fragile, often collapsing when broader tensions flare.

That changed ahead of a November 2023 summit between President Joe Biden and Chinese leader Xi Jinping, when the two governments agreed to launch a multiagency crackdown on Chinese chemical suppliers tied to the fentanyl trade. Chinese authorities subsequently arrested about 300 people and moved to restrict roughly 55 additional synthetic substances — steps Beijing had previously resisted.

The summit, however, happened months after overdose deaths had already begun to fall — a timing mismatch the researchers acknowledge. Humphreys theorizes China may have begun crackdowns months before the agreements were announced.

Again, China may have already started for reasons that have not much to do with the U.S. directly, but the fentanyl production caused trouble for the official Chinese Communist Party internally.

I am not seeing any of the people talking on the record considering this possibility.

“What’s really striking is that parallel across the two countries, even though the two countries [Canada and U.S.] have very different domestic policies,” said Jonathan P. Caulkins, a Carnegie Mellon University professor who researches the criminal drug trade and was a study co-author.

Yeah, it’s not about what Canada or U.S. did… which brings me to the next topic: homicides.

Homicides are down all over the U.S.

I’ve mentioned this a few times over 2025, especially in reference to Chicago:

In that post from September 2025, I pointed out that while yay! Chicago had its homicides way down for 2025… so did:

• Jackson, Mississippi - 50% decrease

• Birmingham, Alabama - 51% decrease

• St. Louis, Missouri - 28% decrease

• Memphis, TN- 25% decrease

• Baltimore, MD - 22% decrease

• Detroit, MI - 19% decrease

• Cleveland, OH - 46% decrease

• Louisville, KY - 30% decrease

• Indianapolis, IN - 30% decrease

• Oakland, CA - 21% decrease

Some people were getting cutesy, trying to say: oh, they’re just not reporting crimes!

Guys, it’s difficult with even the most corrupt police departments to get away with hiding dead bodies… especially so many across the U.S. Or misreporting homicides as different causes of death, given so many homicides are via gun or knife as a weapon.

But even if they were all lying about drops in homicides, there needs to be an explanation as to why they were all lying in concert.

Let’s check in with my favorite Chicago crime site, Hey Jackass!: The 2025 Year in Review

We speculated at the end of 2024 that “maybe the less cops, less tools, more rules has been the winning formula missing for all these years”. Possibly that along with a State’s Attorney that actually enforces the law has pulled off a decade low in hi-speed lead-related incidents despite the Kakistocratic leadership that runs the city and state.

2025: 433 killed, 1,592 wounded
2024: 613 killed, 2,444 wounded
2023: 650 killed, 2,500 wounded
2022: 740 killed, 2,936 wounded
2021: 856 killed, 3,745 wounded
2020: 800 killed, 3,472 wounded
2019: 521 killed, 2,291 wounded
2018: 592 killed, 2,465 wounded
2017: 685 killed, 2,935 wounded
2016: 808 killed, 3,658 wounded
2015: 513 killed, 2,546 wounded
2014: 465 killed, 2,239 wounded
Avg: 658 killed, 2,839 wounded

A breakdown of the year’s non-demonizable, silly decisions because they’ve been starved of opportunities in their own communities where law enforcement is a sickness that needs to be eradicated shows:

…..

We mistakenly believed we had bottomed out in 2024, only to watch the downward trend persist through 2025. In hindsight, we underestimated the significance of replacing a pro-criminal State’s Attorney with one who simply enforces the law as written (despite pro-criminal judges still being a persistent issue).

And here is their graph of homicides by year in Chicago:

If 2014 were included, the count would still be lower than 2014.

I think the owner of the site has the cause-effect wrong, because pretty much everybody does. They think that something that the local politicians and cops did had something to do with the big drop.

If it happened everywhere across the U.S., what do you think?

Unfortunately, I will not have good data for 2025 homicides until about July 2026, because of how external causes of death are released in data from the CDC.

But I do have good data through June 2025, and you can see there was already a separation in shootings in Chicago by the halfway mark each year. I may be able to do an analysis to see the large drop year-over-year and see if there were geographical differences… just as there was a large increase in homicides in 2020.

Motor Vehicle Accident Deaths

This one is not as large in its movement as the ones above.

December 2025, National Highway Traffic Safety Administration, Crash Stats: Early Estimate of Motor Vehicle Traffic Fatalities for The First 9 Months (January–September) of 2025

It’s only comparing year-over-year, so let me compared the worst year (2021) against 2025: at 14% decrease.

That is not as impressive as the large decreases in drug ODs and homicides — but note, the motor vehicle traffic deaths did not increase as much during the pandemic as homicides and ODs did.

The number of deaths is about what we saw in 2018.

Consider, too, that generally, for motor vehicle accident deaths, we usually measure the rate based on the number of vehicle miles traveled… but that’s for another time.

Here is the change in count by region:

The report is only 6 pages long, and includes a table with a state-by-state breakout, so you may wish to look at it for yourself.

Getting back to normal?

At least with respect to the “nasties” of the external causes of death, it may be that some of problematic causes of death may be coming down to less crazy rates that we saw during the pandemic… for a variety of reasons.

People need to have a little humility, though (especially politicians… not that they’re known for being humble), in claiming credit for any of these improvements.

In some of the cases of all of these causes of death, there was a large jump up in deaths during the pandemic, and in the case of drug overdoses, it was a problem before the pandemic. There is still much to be done.

Claiming victory while the death counts are still fairly high is not helpful. And claiming cause-effect chains that do not hold is also not helpful.

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There is a lot more at X.

13 Jan 2026, PJ Media: Scott Adams, ‘Dilbert’ Cartoonist, Author, and Podcaster, Dies at 68

Scott Adams, a cartoonist, author, an independent-minded pundit and podcaster, has died at the age of 68 after a rather public battle against prostate cancer. The host of Real Coffee with Scott Adams, the creator of the legendary comic strip Dilbert, and the author of numerous books, had continued with his livestreaming routine, seven days a week throughout his treatments for the disease up until yesterday. In the process, he treated his audience like close family during his cancer journey.

Adams first entered the American consciousness through the clever and relatable satire of Dilbert, which vividly captured the frustrations, absurdities, and the humor of modern office life. His success with Dilbert enabled him to branch out into self-help books on persuasion, and eventually to carve out a very influential niche as an intelligent observer of American politics, culture and media.

Adams was born in 1957 in rural Windham, New York. While he often recounted that he showed early aptitude for drawing, he initially pursued a more conventional path, earning an MBA and working in banking and telecommunications firms. Years in a corporate setting informed his later work on Dilbert, which debuted in 1989. The strip’s central insight, that organizations often reward the wrong behaviors and promote the least capable people, felt both funny and true.

For generations of white-collar workers, Dilbert was not merely a comic strip; it was a form of recognition of the often unspoken reality of cubicles, corporate-speak, pointless meetings, and managers who were never in on the joke.

One of the things I liked about Dilbert is there were enough spreadsheet jokes that people would clip them out and give them to me, and I’d hang them up in my cube(s).

I had this one hanging up in my cube for years: [mainly because I am notorious for bitching about other people’s horrid spreadsheets]

I think my ma sent me this one:

Finally, this was supposedly Scott Adams’s favorite Dilbert strip:

This reminds me — the way I got my first job in college was by going to the professor in charge of the math computer lab to get an account. Immediately after I said howdy, I asked if it was a Unix network. Then he asked if I wanted a job in the lab. (I got further jobs in the math department later.)

On Recent Advanced Prostate Cancer Trends

Scott Adams died from prostate cancer, the same as my late husband, Stuart.

Adams gave only limited information on his cancer diagnosis, as far as I know. But it seems he was diagnosed when the cancer was advanced, again, the same as Stuart. The greater world heard about Adams’s diagnosis last year, as I spoke about in May 2025:

Rather than show mortality trends today, let me show you diagnosis trends in the U.S., for advanced prostate cancer (which is morbidity, an entirely different thing)

The CDC’s page on prostate cancer incidence breaks out info into 3 age groups, as you see above, and you see the increase in advanced prostate cancer diagnosis (or “distant”, because the prostate cancer cells are found in the body far away from the prostate, usually spread throughout and incurable at that point.)

This data was published 25 Sept 2025, and is the most recent available.

These rates are quoted per 100,000 men per year, as with mortality rates, so in an absolute sense, they are low. But you can see the rate had been level for older men (over age 70) for many years before it started to increase after 2011. More on that in a moment.

Let me zoom in on the younger ages:

The increase for the 55 to 69 year group started earlier than 2011, as you can see.

The rates are very low for the youngest age group of men represented in the data set, but the rates are increasing throughout the period.

Increasing Cancer Incidence at Advanced Stages: Partly Related to Bad Screening Advice

Back in May last year, after we had heard of former President Biden’s diagnosis of advanced prostate cancer, people were incredulous that he hadn’t been screened for prostate cancer in years:

I knew what the advice had been, and it’s bad:

The bad advice had been promulgated in 2011. It is just bad all-around, not just at older ages.

Because of this bad advice, men are putting off prostate cancer screening, and prostate cancer is curable if diagnosed at an early stage, but only treatable if found at an advanced stage. The treatment for prostate cancer gets harsher, and the effects from the treatment or the cancer are more profound, the more advanced the cancer.

Here is better screening advice from the American Cancer Society: (last revised November 2023)

[I added some italicization]

The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the possible benefits, risks, and uncertainties of prostate cancer screening. The discussion about screening should take place at:

• Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years

• Age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).

• Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)

After this discussion, men who want to be screened should get the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening. (See Screening Tests for Prostate Cancer.)

If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the man’s general health, preferences, and values.

If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:

• Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.

• Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.

Because prostate cancer often grows slowly, men without symptoms of prostate cancer who have less than a 10-year life expectancy should not be offered prostate cancer screening, because they aren’t likely to benefit from it. Overall health status, and not age alone, is important when making decisions about screening.

I discuss the 10-year life expectancy issue in this post. It occurs at an age much higher than 70 years old.

All that said, if you look above, you can see that the screening advice cannot be the only explanation for the trend. There is a general increase in incidence in advanced prostate cancer at all ages, and the increase started in earlier years for younger ages.

Still, screening recommendations seem to be the largest factor.

“Distant” = advanced prostate cancer.

The group with the highest incidence is non-Hispanic Black. The lowest is non-Hispanic Asian/Pacific Islander. Everybody else is kind of clustered together.

You can see the incidence had been going down until 2010… and then started going up in 2011.

I don’t know what Scott Adams’s situation was, re: the cancer. Some men end up with advanced prostate cancer, even with regular screenings (if it’s an aggressively growing cancer)… but you are more likely to find cancer at an earlier stage (if you have cancer) if you have the screenings.

Not looking for cancer does not mean the cancer isn’t there.

Scott Adams was a highly influential person, and I hope one of his influences is on men to prioritize their health.

Related Posts

• Nov 2025: Movember 2025: Prostate Cancer U.S. Mortality Trends Update - discusses PSA screening

• May 2025: President Biden Had Followed Bad Prostate Cancer Screening Guidelines -- Here are Better Ones

• Oct 2025: Geeking Out on Cancer: The Difference Between Incidence Rates From Screening and Types

• Nov 2021: Movember: The Improvement in Prostate Cancer Mortality - talks about PSA screening

• Nov 2022: Movember 2022: Prostate Cancer Mortality Trend Update - talks about stalling out of mortality improvement, and screening being missed

• May 2025: Podcast: On Advanced Prostate Cancer: Some Personal Thoughts on Biden’s and Scott Adams’s Announcements

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6 January 2026, CalMatters: Rep. Doug LaMalfa, a steadfast advocate for California’s North State, dies at 65

Rep. Doug LaMalfa, a fourth generation rice farmer and Republican who represented much of California’s rural north in Congress, has died in office, setting off a scramble to replace him ahead of the November midterm election. He was 65.

His unexpected death Tuesday further shrinks the party’s already razor-thin majority in Congress, which now stands at 218 following Georgia Rep. Marjorie Taylor Greene’s resignation. The GOP can now only afford to lose two members on any party-line vote.

LaMalfa’s passing also sets up a potentially confusing scenario for his constituents in the 1st Congressional District, one of the five that were significantly redrawn under the voter-approved Proposition 50 last year.

Under California law, Gov. Gavin Newsom must call a special election within 14 days to fill the remainder of LaMalfa’s term. That election will take place using the existing congressional district map, a seat that stretches from much of the Oregon-California border through rural Shasta and Sutter counties and strongly favors Republicans.

6 Jan 2026, KDRV: New details and information released on the death of Congressman Doug LaMalfa

Congressman Doug LaMalfa was rushed to Enloe Health in Chico on Monday after a medical emergency took place at his home in Richvale.

The Butte County Sheriff’s Office says that they received a 911 call from LaMalfa’s residence around 6:50 p.m. on Monday night. The call was transferred to medical personnel, who arrived at the scene and transported Congressman LaMalfa to the hospital.

Upon arrival at Enloe Health, LaMalfa was taken into emergency surgery, where he later passed away. Friends close to LaMalfa told Action News Now that he had been experiencing stomach pain and then suffered from a local aortic aneurysm, a condition where part of the aorta becomes weak and balloons outward in one spot.

….

Multiple members of Congress indicated LaMalfa suffered a heart attack during surgery. Meanwhile, the Butte County Coroner’s Office is investigating the cause of death, with a forensic pathologist scheduled to perform an autopsy on LaMalfa.

The Wikipedia article on Doug LaMalfa’s death currently says “heart attack” as the cause of death, using the favored Wikipedia source Politico. I have a feeling we can wait a few weeks for a formal ruling on this [aortic aneurysm leading to cardiac event, etc.]

In any case, that’s down one Republican representative (for now). With 435 representatives that had an age distribution that looked like this last year:

Yeah, you expect a few deaths every year.

I didn’t even put the sex-related lopsidedness, which would place the expected number of deaths higher than if it were 50/50 male/female split.

In addition: 6 Jan 2026, Politico: Indiana congressman Jim Baird and wife hospitalized after car crash

Indiana Rep. Jim Baird and his wife are being hospitalized following a serious car crash, President Donald Trump confirmed in televised comments to House Republicans on Monday.

“They’re going to be OK, but they had a pretty bad accident,” Trump said at the top of his address to a House GOP legislative retreat, where he also paid tribute to the late California Rep. Doug LaMalfa following his sudden death Monday.

So that’s another representative down, though not dead. Not exactly available for votes.

Updated 2020s House Deaths Table

Yes, there is such a table in Wikipedia, but I like the way I format my table better:

You can see that three Democrats (Texas, Arizona, Virginia) died in 2025, and since then:

• The last to die, Gerry Connolly, was the first to be replaced — James Walkinshaw won a special election in Virginia’s 11th district in September 2025 and was seated in the House on September 10, 2025.

• Raúl Grijalva’s daughter Adelita Grijalva was elected in a special election to replace him in the 7th district of Arizona (seated Nov 12, 2025).

• Sylvester Turner, the first to die in 2025, has yet to be replaced. A special election was held in November 2025, but no candidate received enough votes to win outright. Two Democrats are remaining for a run-off election on January 31, 2026.

So here is the full list of currently vacant House seats:

• California 1 — Republican Doug MLaMalfa’s death.

• Georgia 14 — resignation of ex-Republican Marjorie Taylor Greene. Special election in March.

• New Jersey 11 — vacated by the current Democratic governor of New Jersey. Special election will be held in April.

• Texas 18 — Democrat Sylvester Turner’s death, special election run-off at the end of January.

Of course, there’s an election for all the seats in November, but more on that after we look at the current age distribution for the 431 remaining representatives.

Age Distribution in the House, January 2026

Distribution of Ages in House of Representatives by Party, January 2026

There hasn’t been a new full election since the last time, so it’s mainly a case of aging (yes, a few deaths, but that’s just a couple).

For a few key stats:

Median age:

• Democrats: 57

• Republicans: 58

Mean age:

• Democrats: 58.5

• Republicans: 57.3

Modal age:

• Democrats: 49 (9 reps)

• Republicans: 55 (10 reps)

Average Age of Representative by State, January 2026

Obviously, in some of these cases, the states have only one representative and we’re seeing the age of that person.

There may have been some deliberate shifts in the ages of the congressional delegations in some states — more Millennials getting into the game, so good for them.

Upcoming Election

There is an election coming up this November, you may have heard.

I will get to the Senate soon enough, but for the House, the representatives are all up for election.

People have complained about the advantage that incumbents have, but they don’t have much advantage when the ravages of time take their toll.

Mortality rates exceed 1% for the overall population for ages 58 for males and 64 for females in the general population (check out the Social Security life tables), so you can expect a few people to die out of the 435 in the House each year, even with a better-than-1% expected mortality in the House.

It’s only to be expected.

If anything, the mortality of the House is a little lower than the general population, from what I can tell. I didn’t break out the House age distribution by sex, but if I thought something odd was going on, I’d definitely do that.

Age is far more of a deciding factor on mortality than sex — that the average age is about 58 is far more relevant in estimating the expected number of deaths per year than the sex ratio.

I will update the Senate age distribution graph soon. Senators aren’t all up for re-election each time, but they tend to be far older than the House.

That has consequences.

Spreadsheet

House Deaths And Demographics 2026 01 09

4.04MB ∙ XLSX file

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• 10 Apr 2025: Congressional Mortality Has Consequences

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It’s the 5th day of Christmas and I do not have any gold or golden rings for you.

I have a warning of SEASONAL DEAAAAAATH.

Yes, that January 2022 spike was the tail-end of the acuteness of COVID in the U.S.

COVID does persist, but it slipped down to the 15th highest cause of death for 2024, and even with external causes of death being censored for 6 months, it’s fallen completely off the top 15 in 2025. Just in case you were wondering.

We’re back to the standard seasonal pattern of deaths, and it’s driven by the oldest folks. Flu and pneumonia are one of the big drivers for the seasonality of deaths among the elderly (and the older you go, the more seasonal the pattern of deaths), but as I’m ensconced in a warmer clime than NY and am reading what I’ll be going back to, I want to warn about two other seasonal dangers that get folks: falls and cardiac death from shoveling snow (mainly middle-aged men.)

Don’t Shovel Snow, Weekend Warriors!

Here is this year’s warning from the American Heart Association:

12 Dec 2025: Arctic plunge to bring sub-zero temps and snow; take extra care to stay heart healthy

The American Heart Association’s 2020 scientific statement, Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update, notes snow shoveling among the physical activities that may place extra stress on the heart, especially among people who aren’t used to regular exercise. Numerous scientific research studies over the years have identified the dangers of shoveling snow for people with and without known heart disease.

In my extended family recently this year, one of my relatives in his early 50s, an avid pickleball player, was found to have major cardiac artery blockage after he was suffering symptoms of a “minor” heart attack. Like most of my family, he lives in the South, so not much snow-shoveling to tax him… but the pickleball almost did him in.

(CAUTIONARY TALE)

(I’m joking a bit on the pickleball)

(CAUTIONARY TALE)

But seriously, too many people have no idea how much snow-shoveling taxes their bodies (and how much their arteries are blocked). It’s the combo of the strain and the cold that does it for people:

Rosen says someone who’s not as active during the year and then picks up a snow shovel in the winter may not realize the extreme cold and exertion forces your heart to work harder, sometimes dangerously harder.

• Shoveling is primarily arm work, which is harder on the heart than leg work.

• Lifting heavy loads often causes people to hold their breath without realizing it, spiking heart rate and blood pressure.

• Cold air constricts blood vessels throughout the body, raising blood pressure and tightening coronary arteries.

The risk is even greater for people with cardiovascular concerns such as a sedentary lifestyle, obesity, smoking history, diabetes, high cholesterol, high blood pressure, or a prior heart attack, stroke or other cardiac condition. Talk to your doctor about any limitations on your winter activities based on your heart health.

They have advice in the piece, but my advice is GET SOMEONE ELSE TO DO IT.

That “somebody else” could be a snowblower… (or, in my case, my adult children). My other advice is to use a ratty broom if you are able to, for light snow. We mainly sweep our snow when we can.

At 51, I avoid shoveling as much as I can. That’s as a 51-year-old female, y’all.

Of course, most of the people dying due to sudden cardiac death are male:

The research paper they refer to is Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update: A Scientific Statement From the American Heart Association, a meta-study from March 2020, and the portion related to snow-shoveling is the portion on short-term relative risks of sudden cardiac death:

Sudden Cardiac Death

Several studies of differing designs, primarily of men, have estimated the RR [relative risk] of SCA [sudden cardiac arrest] and SCD [sudden cardiac death] during vigorous exertion compared with rest or more moderate PA [physical activity].^43,48,68,69 In a prospective case-crossover analysis of men in the US Physician’s Health Study, the risk of SCD was transiently elevated ≈17-fold in the period during and up to 30 minutes after vigorous exertion.

….

The absolute incidence of exertion-related SCD and MI [myocardial infarction…aka heart attack] increases over 35 years of age,^51,70 with the greatest numbers of exertion-related SCDs reported between 40 and 64 years of age.⁵¹

….

Snow shoveling has repeatedly been associated with increased cardiovascular events soon after major snowstorms,^105–107 probably because it can elicit higher rate-pressure products than maximal treadmill testing¹⁰⁸ and is often performed by unfit individuals with known or occult CAD. Also, some cardiac patients develop angina at lower rate-pressure products during exercise in cold temperatures,¹⁰⁹ possibly because of cold-induced vasospasm. Ventricular arrhythmias, coronary plaque rupture and ST-segment–elevation MI,¹¹⁰ and subacute stent thrombosis¹¹¹ have also been reported with snow shoveling.

So, yes, men, you start getting “old” … well, older, at about 35. That’s when middle age begins. I’m not saying stop shoveling snow at that age.

I’m saying: PAY ATTENTION TO YOUR HEALTH.

Prior post:

Falls are Dangerous to Seniors

I was not expecting the following from the author of The Joy Luck Club, but as she is 73 years old herself, and she mentions her friends had issues… well, you can see.

From Amy Tan on Facebook, 22 Dec 2025: [emphasis added]

Here is my annual posting of HOW NOT TO FALL.

First, an update: In the last few months, three close friends fell and suffered significant injuries. One required stitches and had post-concussive syndrome. Two required surgery, very long hospitalizations, and ongoing therapy in a skilled nursing facility. One now has quadriplegia. They are all over 70.

Here are the reasons they fell: One tripped when not scanning ahead to see the tree roots that had broken up the path. Another had a cell phone tucked under her chin and books in her hands. She tripped on an old thin bath mat that had no anti-slip backing left. The other friend fell down steep winding stairs that were poorly lit.

There are alarming statistics concerning women over age 65 who suffer hip fractures from falls. According to one scientific study, the one year mortality rate was 27%, meaning 1 in 5 women will die in the first year, usually related to complications, such as blood clots, infection, additional falls, or pneumonia that can develop when a person is less mobile. And men don’t get a break, so to speak, with the statistics. They suffer more injuries and death from falling than women. Some of this may be due to the fact that men tend to place themselves in riskier fall situations, for example, cleaning gutters while standing on a tall ladder.

Since many of my followers are over 60, here is some advice to prevent falls. Most of them are my own “live and learn” lessons from falls I’ve had and the factors that put me at risk.

1. ALWAYS USE THE HANDRAIL WHEN TAKING THE STAIRS OR A STEEP INCLINE. Not counting spills in childhood, I estimate I’ve fallen down stairs a half-dozen times over my adult lifetime and for various reasons. I’ve tripped over things and fallen on stairs in the dark when what I thought was the last step was not the last. Most would not have happened if I had used a handrail. Consider installing handrails leading up to your front door. If you think you don’t need it, think about elderly friends or relatives who are not as fit as you.

2. CONSIDER AREAS WHERE HANDRAILS ARE NEEDED. Typically, these are places where a number of people have already fallen. Going down steps of the house. Going down pathways that are slippery in the rain or when covered with moss. Walking down uneven steps.

3. USE A FLASHLIGHT WHEN WALKING DOWN STEPS OUTDOORS. GIVE ONE TO GUESTS TO USE. If you have stairs leading to your front door and do not have a brightly lit path that illuminates steps ahead, use a flashlight. Although our stairs are lit, older guests may have impaired vision. I have about five rechargeable waterproof and extremely bright flashlights. Guests place the flashlights in our mailbox at the bottom of the stairs.

Consider adding reflective strips on stairs so that the edges of steps are apparent.

4. WHEN GETTING UP IN THE MIDDLE OF THE NIGHT, USE A PORTABLE LIGHT OR AUTO-ON NIGHTLIGHT. I’ve stumbled over dog toys, a slipper, a stool, etc. in the dark. I use one of those clip-on reading lights, which is always nearby for reading books. And before going to sleep, I check the path between the bed and the bathroom.

5. DON’T CARRY ITEMS IN BOTH HANDS WHILE DESCENDING STAIRS, INCLINES OR UNEVEN SURFACES. Those items may block you from seeing obstacles or uneven steps. A friend who used both hands to carry a car seat with her grandchild strapped into it missed the last step and managed to keep the baby from hitting the pavement but did some damage to herself. A friend insisted on carrying boxes of Christmas gifts in both hands while going down the front stairs and missed the last step and fell forward onto the gifts. If possible, use large bags with handles to hold bulky items, so you can see what is in front of you, while freeing one hand to take the rail.

6. CHECK SURFACES INSIDE AND OUT THAT MAY BE SLIPPERY. My husband recently slipped and nearly fell on a sloped walkway that had accumulated algae from the winter rains. Fortunately, he grabbed onto the rail and did not crash to the ground. I slipped turning a corner after an over-zealous new housekeeper used wax to polish our wood floors to a high sheen. For outside steps and pathways, I have used straight 2% hydrogen peroxide from a spray bottle to remove algae. H202 deteriorates to water within 24 hours and does not kill plants the way bleach does. In fact, hydrogen peroxide can be used to treat root rot and bacteria and to release more oxygen in soil.

7. NEVER LOOK AT YOUR CELL PHONE WHILE WALKING. That goes for inside the home and out. I know of two older friends who recently fell while looking at their cell phone. One tripped over a bag, and another did not take into account the greater height of her friend’s car as she stepped out while reading email. A firefighter in NYC told me that one of the leading causes of pedestrian deaths is inattention while looking at a cell phone, and the number of deaths is even higher for those also wearing headphones.

8. ROUTINELY SCAN AHEAD TO NOTE OBSTACLES AND CHANGING CONDITIONS. I once was engaged in talking to someone as we strolled on a level walkway. I did not notice that the flat walkway was becoming an elevated sidewalk with a 5” curb. My left foot rolled off the curb and I fractured my ankle. Fortunately, it was not my hip.

9. BE AWARE OF WHERE YOU PLACE THROW RUGS AND ESPECIALLY RUGS THAT DO NOT LIE FLAT. Falls can happen when your foot catches the edge or when rugs are slippery and lacking grippers. People walking fast or turning corners in the house can send a rug flying. This is a real danger for those with balance problems, such as those with Parkinson’s or MS.

10. CONSIDER INSTALLING GRAB BARS IN YOUR SHOWER OR TUB. Amost 80 percent of falls in the home occur in the bathroom, and according to the CDC, more than 200,000 seniors are treated in emergency rooms each year for bathroom-related injuries. I am actually surprised how many bathrooms of friends have deep tub-and-shower combos, and only a slippery tiled wall to lean against and faucet handle to grab onto. They cite that grab bars are ugly, yet their own bathroom is not on regular public display. You can slip when you step in and balance on one leg. You can slip on a bar of soap or when tub bottoms have an invisible layer or shampoo or conditioner. You can lose your balance when you close your eyes for more than a few seconds, as might happen when shampooing and rinsing hair. Your balance is simply not as good when you can’t see. Try standing on one foot with eyes open and then closed. I speak from experience. I have fallen in the shower of a former home that had very slippery tiles and nothing to grab onto. Another fall occurred when I already had a broken leg in a cast and had use of only one good leg in the shower. Another fall occurred in a hotel with a curved tub, which led to my shooting up and over the tub and landing onto a very hard floor. I have nearly fallen many times when using shower-tubs in hotels and the homes of friends. Oh, and those bath mats with grippy suction cups. Did not work for me. Soap on plastic is dangerous.

If you use a shower chair, be aware that it may not be stable to lean against if the shower floor is slippery.

11. CONSIDER INSTALLING A GRAB BAR NEAR THE TOILET. I have had more than one elderly guest rip off the towel bar or toilet paper holder when they leaned on them to stand up. Low toilet seats are a challenge for some. Mask the grab bar by hanging a small washcloth over it. There are many websites that sell attractive grab bars that don’t resemble those ugly aluminum ones you see in hospitals.

12. BE CAREFUL IN BATHROOMS WITH MARBLE, GRANITE or POLISHED TILE FLOORS and SHOWER BOTTOMS. I once fell three times during the course of my stay in a hotel that had beautiful marble floors that housekeeping polished to a shine. Actually, I am baffled why people install bathrooms with highly slippery flooring. Are the aesthetics really worth the risk? When choosing tile for a bathroom, consider small, unpolished tiles, like penny tile, connected by grout.

13. WEAR NON-SKID SHOWER SLIPPERS. Choose ones that have non-slip properties when walking on wet surfaces. Smooth-bottoms are not good. I bring shower slippers when I travel for hygienic and safety reasons. Many hotel showers are slippery.

14. BE AWARE OF DOGS AND CATS THAT TEND TO GET UNDERFOOT. Unless you have trained your pets to not rush ahead of you, you will need to check if your pet is following you. Dogs, for example, barrel head when the doorbell rings. A friend of mine tore her ACL when she tried to avoid falling on her little dog. Another friend broke her foot when her cat scooted under her as she was going down the stairs.

15. GET IN A BALANCED POSITION BEFORE STEPPING OUT OF THE CAR. I once hurriedly stepped out of the car on one foot when the door was not fully open. I was off balance sideways with one foot still in the car and when I lost my balance, I had nothing to grab onto and fell backward and hit my head on concrete. That’s one way to end your writing career. I recommend opening the door fully, and swinging your legs out together while seated so that both feet are on the ground before standing up. Be a triangle, not a T.

16. SLOW DOWN WHEN TURNING FAST OR CHANGING DIRECTIONS. When you turn, your required balance shifts. I fell when I stepped outside onto the patio, immediately turned, lost my balance, and fell onto a bunch of flower pots. Lots of bruises. I have slipped (without falling) a number of times turning corners in the house.

17. REMOVE OBSTACLES ON THE FLOOR, like magazines, clothes, dog toys, and charging cords. I know of one author who broke a leg when he got out of bed and immediately stepped onto a magazine. I fell when I stepped on loose clothes on the floor that I was about to pack for a trip.

18. IF YOU GO BAREFOOT OR WEAR SOCKS ONLY INDOORS, USE GRIPPY SOCKS. They are also sold as yoga socks. They often look like ballet slippers and can fit over socks easily.

19. USE A STEPSTOOL AND HAVE SOMETHING ANCHORED THAT YOU CAN GRAB ONTO WHEN TALKING DOWN ITEMS FROM A HIGH SHELF. I know of people who fell when they stood on collapsing tables, chairs, ottomans, and boxes. Keep in mind that once you take something off from a high shelf, your balance shifts. You don’t want to have to decide between a box of Christmas decorations and a concussion. Consider installing grab bars in your closet or garage that you can hold onto when taking down items on high shelves.

20. THINK TWICE BEFORE USING A LADDER, INDOORS OR OUT. My husband had a ladder slide out from under him when he was changing a light bulb on a 14’ high ceiling. He was lucky he was not killed. A high percentage of men who die of falls at home were on tall ladders or on the roof, cleaning gutters. We installed LED lights in our home so that we will not have to change lightbulbs as frequently. And when they need to be changed, we will hire a handyperson with a ladder to handle that task and other safety needs that may come up throughout the year.

21. BE AWARE OF TRIPPING IF WEARING LONG SKIRTS, PANTS, HIGH HEELS or LOOSE SLIPPERS. While going down stairs, I’ve tripped on skirt and pant hems. I also slipped wearing loose slippers and sandals. Sharply-pointed high heels can get caught on rugs.

22. GIVE UP TRYING TO LOOK THREE INCHES TALLER. Switch to stable shoes without heels or wedges. Avoid wearing shoes that are too big. And be aware that cushy tall foam slides are comfortable but not that the best for stability on stairs and such.

23. DO CORE BODY EXERCISES TO STRENGTHEN BALANCE and FLEXIBILITY. Core body exercises are not necessarily the same as muscle strengthening exercises. It is not the same as running on a treadmill. So look up the types of exercises that improve balance AND flexibility. Older people who are less flexible tend to move their upper and lower body as one unit. Practice turning your head to the side one way and the other. Turning your head to see something is better than turning your whole body. You can find exercise and stretching suggestions on YouTube, from a personal trainer, or from a physical therapist. Do the exercises at least three times a week.

24. BE PROACTIVE IF YOU LIVE WITH SOMEONE WHO IS OLDER OR WHO HAS MOBILITY IMPAIRMENTS. It could be someone who has weakness from a stroke, cancer, Parkinson’s, MS, arthritis, osteoporosis—any disease that impairs coordination or is high risk because of fragility. You may not have problems, but consider the safety needs of your family or friends who visit or stay overnight.

25. DO AN ANNUAL ASSESSMENT FOR FALLING HAZARDS IN YOUR HOME, INSIDE AND OUT. Hazards change. If you have kids or grandkids or dogs over, obstacles increase. If you have snow or ice, accumulated leaves, or a lot of rain, your walkways will be slippery. If you are moving into a new home, do a run-through on safety issues, especially in the bathroom. There are some YouTube and Tik-Tok videos that show all the “hilarious ways” that people fall. I always wonder what happened to those people after the video ends. I imagine the outcome did not remain hilarious to the person who suffered the fall.

26. LEARN HOW TO FALL SAFELY. If you are falling, be like a child—squat to get lower and roll into the fall. Watch videos on YouTube, and practice quickly lowering yourself, although not simulating a complete fall. If you have fallen, you’ll no doubt be shocked. Try to determine if you are injured and where. If you hit your head, it may not be wise to move until you assess your injury. When people help you stand, do not have them pull you up by grabbing onto one hand. That was how I sprained my wrist. Have them support you under the armpits. I prefer to have people wait and see if I can get up on my own.

Have a healthy 2026!

Her list is rather thorough, and I think it’s too long. Yes, people should follow that, but most people who need this advice need to learn that their situation is dangerous — that they’re FRAGILE and they need to act accordingly.

Ivana Trump, who died from a fall down her stairs at age 73 (the current age of Amy Tan), could have been told “GIVE UP TRYING TO LOOK THREE INCHES TALLER” and a warning against the beautiful marble floors as a danger…. and ignored it. It’s tough.

Here’s my list:

1. Learn how to fall safely, as she said. DO NOT BREAK YOUR FALL WITH YOUR HANDS… you will break your wrists and hurt yourself horribly. I learned that one when I was pregnant.

2. You need to senior-proof your home as you age, just as you had to baby-proof/child-proof your home when that was relevant. Be realistic about visual, aural, balance, strength, etc. skills. This can be for you, relatives, etc.

3. Work on your balance and walk. Or test it. Some people become more prone to falls because they walk too slowly and become unbalanced. Humans are inverted pendulums as bipeds, and that’s an inherently unstable situation. If you’re going to be too slow, and unable to stand steadily, you may need a cane or walker for stability. If you think using a cane or walker is undignified, let me tell you, breaking a hip from a fall is not more dignified.

Someone should put together seminars/classes for these things (with liability waivers) with big cushions so people can practice falling down. Ideally, they’d learn when they’re 60, and pre-osteoporosis.

But the main thing would be to have some thorough balance, gait, and low-light vision tests for seniors, so that they can come to grips with the reality that they need to make adjustments to their living conditions so that they don’t injure themselves unnecessarily in their own homes.

I have plenty of FALLS ARE DANGEROUS links (scroll down), and with ice out there, there are many dangers for even younger folks (though we’re less likely to break a hip from sliding and falling).

The main product I use for dealing with walking on ice is Yaktrax:

I’ve used them for decades, since I first saw them at an REI in Raleigh. They’re rubbery webs covered in metal springs that go over your shoes. They work pretty well on ice. But they’re not for walking inside, and not much with slippery leaves.

FALLS ARE DANGEROUS Posts

• 16 Oct 2025: Falls are Dangerous: RIP, Ace Frehley and Watch Out, Sen. McConnell

• January 2025: Falls are Dangerous for Seniors: Nancy Pelosi and Pope Francis

• April 2024: Revisiting Death by Falls: Characteristics

• March 2024: RIP Joe Lieberman -- A Reminder that Falls are Dangerous to Seniors

• July 2022: The Death of Ivana Trump: Falls are Dangerous for Seniors

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Former Sen. Ben Sasse announced on Tuesday that he has been diagnosed with stage 4 metastatic pancreatic cancer.

The Nebraska Republican shared the news on X, writing in a lengthy social media post that he had received the diagnosis last week.

“Advanced pancreatic is nasty stuff; it’s a death sentence,” Sasse said. “But I already had a death sentence before last week too — we all do.”

The two term senator retired in 2023 and then went on to serve as president of the University of Florida. He eventually left the school to spend more time with his wife, Melissa, after she was diagnosed with epilepsy.

Sasse continued to teach classes at University of Florida’s Hamilton Center after he stepped down as president. He previously served as a professor at the University of Texas, as an assistant secretary at the Department of Health and Human Services and as president of Midland University.

Sasse’s statement on X is here:

Friends-

This is a tough note to write, but since a bunch of you have started to suspect something, I’ll cut to the chase: Last week I was diagnosed with metastasized, stage-four pancreatic cancer, and am gonna die.

Advanced pancreatic is nasty stuff; it’s a death sentence. But I already had a death sentence before last week too — we all do.

I’m blessed with amazing siblings and half-a-dozen buddies that are genuinely brothers. As one of them put it, “Sure, you’re on the clock, but we’re all on the clock.” Death is a wicked thief, and the bastard pursues us all.

Still, I’ve got less time than I’d prefer. […..]

It’s a long post, so you can go there to read it all. I will return to a part of it at the end of this post.

It’s that family Christmas letter no one wants to receive.

Prior Pancreatic Cancer Posts

This may seem like deja vu, in that a prominent politician died from pancreatic cancer not that long ago: Rep. Sheila Jackson Lee.

• 27 Sep 2024: Cancer Watch: Pancreatic Cancer, Young Adults, and Men’s Health

• 20 Jul 2024: RIP, Rep. Sheila Jackson Lee: An Update on Pancreatic Cancer Death Trends

• 6 Jun 2024: Pancreatic Cancer Trends: 1999-2023, U.S.

• 8 Feb 2024: Top Cancer Types: By Crude Death Rate, 1968-2023

Unlike ex-Sen. Sasse, Rep. Lee was a bit in denial as to her survival chances when her cancer diagnosis was announced. To be sure, they didn’t announce her cancer was metastatic, but you can look at the survival stats I compiled in 2024:

Even when localized, the 1-year relative survival rate for pancreatic cancer is not good.

U.S. Pancreatic Cancer Mortality Trend: Large Jump Up in 2024, Driven at Older Ages

The spreadsheet with the updated info will be at the bottom of the post.

It is difficult to interpret the movements of rates for the youngest age groups — for ages 25-34, there are fewer than 100 deaths per year; for ages 35-44, there are fewer than 500. A lot of the movement can be noise.

But once we start looking at the ages 55 and older, we can see there have been some serious increases in the rates of deaths due to pancreatic cancer. It may be related to the rise in diabetes and other metabolic problems in general.

To be sure, many of the people suffering from pancreatic cancer do not have diabetes. I am not linking some of the papers I reviewed, but some of the increase in pancreatic cancer deaths in official stats may come from better detection… right before people die. Given that most pancreatic cancer incidence and death is in older people, the biases are such that in prior years, the cancer may have gone undetected and deaths may have been recorded due to other causes.

That’s always the issue with data — it can be difficult to tell if this is a real signal or not.

Ben Sasse’s Message: Some Hope for Christmas

I said I’d return to Ben Sasse’s message:

I’ll have more to say. I’m not going down without a fight. One sub-part of God’s grace is found in the jawdropping advances science has made the past few years in immunotherapy and more. Death and dying aren’t the same — the process of dying is still something to be lived. We’re zealously embracing a lot of gallows humor in our house, and I’ve pledged to do my part to run through the irreverent tape.

But for now, as our family faces the reality of treatments, but more importantly as we celebrate Christmas, we wish you peace: “The people walking in darkness have seen a great light; on those living in the land of deep darkness a light has dawned….For to us a son is given” (Isaiah 9).

With respect to advances, I asked Gemini to give me a comparison of current relative survival rates against 10 years ago:

These differ somewhat from what I have above, but are in the ballpark range. These show a significant improvement over the past decade.

In seeking stories of improvement related to pancreatic cancer, I found the Let’s Win Pancreatic Cancer website, which is filled with such stories.

Let’s Win’s about page:

In May 2014, Anne Glauber learned she had stage IV pancreatic cancer. She and her family were stunned and devastated, not knowing where to turn but knowing they had to do something urgently. That overwhelming fear and confusion became the genesis for Let’s Win.

….

Legacy

In 2017, Anne passed away after living three times longer than originally predicted. Today, Let’s Win is Anne’s legacy, and it stands as a valued resource in the pancreatic cancer community. It is a living testimony to Anne Glauber’s commitment that no one would ever again need to face a diagnosis like hers without resources and hope.

This is similar to my experience with Movember and Stuart. He was diagnosed with metastatic prostate cancer, fought til the end, and lived longer than the usual life expectancy predicted for that diagnosis.

Let’s Win highlighted some of the research breakthroughs for pancreatic cancer treatment from the 2025 ASCO meeting. For example:

Tumor-Treating Fields Improve Overall Survival

Final results of the phase III PANOVA-3 trial show small but statistically significant gains in overall survival in patients with locally advanced pancreatic cancer. In the trial, patients who were given the combination of tumor treating fields added to gemcitabine and nab-paclitaxel in first-line therapy had an improvement of two months in overall survival compared with gemcitabine/nab-paclitaxel alone.

The trial is the first to demonstrate a statistically significant overall survival benefit in locally advanced pancreatic cancer, the researchers said. The addition of tumor-treating fields to first-line chemotherapy can not only extend overall survival, but it does so without increasing systemic toxicity among patients. Patients who received tumor-treating fields plus chemotherapy also experienced prolonged pain-free survival and distant progression-free survival compared with those who received chemotherapy alone.

Much of the improvement in the treatments come not only from the researchers and doctors working on developing them, but also the patients willing to try and fight through to the end.

The piece above mentions “without increasing systemic toxicity”, because chemotherapy is generally poison. It’s trying to kill the cancer cells, but often non-cancerous cells are often killed (and the results can be nasty, such as one’s toenails falling off). For metastatic cancer, given how widespread the cancer can be throughout the body, the methods to attempt to treat can be very harsh indeed… it can be a question of whether the cancer or the chemo kills the person.

I wish Ben Sasse well in his treatment journey.

It is a difficult journey.

Spreadsheet

Pancreatic Cancer 1999 2024 2025 12 24

104KB ∙ XLSX file

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But I wanted to show the final donation take (though I’m sure the Movember foundation would continue to take donations…)

I raised over $1,500 this year, which is a significant improvement over my pre-pandemic fundraising efforts.

I marked my 2024 outlier — obviously, I got much more in donations, as I asked for donations after Stuart died from prostate cancer at the end of September 2024, and Stu’s timing was impeccable for the fundraising boost. Hey, Stu always knew how to make an exit.

Since 2017, I have raised almost $20,000 for the Movember Foundation ($19,853, to be exact.)

I will keep plugging away at the Movember fundraising, not just due to Stu’s memory. I talk about my motivations here from last year:

Links to this year’s Movember posts on men’s mortality and health issues are at the bottom of this post.

But first, let a male-only cause of death ranking table for 2024. A downloadable spreadsheet is at the bottom of the post.

Ranking Causes of Death 2018-2024, Count, Males, U.S.

Back in July, I posted a similar ranking table, but for the entire population.

Just for the count, I will post the full population ranking table:

One difference jumps out at me immediately: suicide is ranked much higher for males as a cause of death than for the overall population.

In the pre-pandemic years, it had been at 8th for men…. and post-pandemic, it has been at 7th, and I do not like this trend. The numbers have increased. It’s not merely that lower-ranked causes have dropped in numbers.

I have been appalled by both the drug overdose and suicide trends, and the societal situation has not been conducive to reversing those.

Let’s take a look at the rates before I comment further.

Ranking Causes of Death 2018-2024, Rates, Males, U.S.

Looking on a age-adjusted death rate basis, suicide death rates have been fairly level for men. But that’s only recently.

That level suicide death rate is a recent high point. So yay that it seems to have leveled off in rate lately, but can that be reversed? And what about those drug overdose deaths?

On the flip side, there is also the plateauing of prostate cancer deaths. That’s another cause linked with Movember — we can see all the improvement over the years, but that has stalled.

Is that related to changes in screening recommendations, such as the ones that led President Biden’s prostate cancer not being found until it was in an advanced state?

To quote myself:

I’m going to drop a few more detailed ranking tables for you to ponder. But I’m not going to say much about them right now.

Ranking Causes of Death 2024, Count, by Age Group, Males, U.S.

Two causes of death I want to point out, but also note the number of deaths under each and remember this is for the entire U.S.

The 9th highest cause of death for males age 15-24 was “legal intervention” (aka “death by cop”).

But it was only 107 deaths. And among the age groups, it’s not even the one with the highest number of deaths by legal intervention:

Older men are more likely to have run-ins with the cops… but they are also more likely to die from all sorts of things.

Which brings me to the second cause of death of note: HIV/AIDS, which shows up as #8 for males age 25-34.

“Only” 317 men died of HIV/AIDS, age 25-34 in 2024. Let me show you the numbers from an earlier era: [likely an undercount]

That crude death rate is fairly hideous for such young men.

Speaking of which, let’s look at rates.

Ranking Causes of Death 2024, Rate, by Age Group, Males, U.S.

I use percentages instead of per 100K for my tables, because people have trouble with thinking about “per 100,000”.

Let’s think about that 47 per 100,000 in 1994 for HIV/AIDS deaths for men age 25-34.

That’s 0.047%.

Compare that with the current top causes of death for that age group:

“Accidents”: 0.074%, which includes traffic accidents… and drug overdoses.

Suicide: 0.028%, which is lower than the rate of HIV/AIDS deaths for men in that age group in 1994, just 30 years earlier.

It’s great to acknowledge the progress in the medical treatment of HIV/AIDS (because, not sorry, it’s not that human behavior changed.)

Another cause of death I’m keeping an eye on is stroke.

It’s not a specific Movember cause, but I’m interested in men’s health in general.

Drug overdoses and suicide are definitely a crisis for men.

That Movember has added men’s mental health as one of their core areas to support has only made me more apt to continue with my fundraising and support of the organization.

Spreadsheet

Male Underlying Cause Of Death 2024 Preliminary Stats And Ranking Age 2025 12 19

297KB ∙ XLSX file

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2025 Movember Links

• 19 Nov 2025: International Men’s Day and the Mortality Sex Gap

• 16 Nov 2025: Podcast: Movember 2025: Continuing On

• 11 Nov 2025: Veterans and Suicide

• 7 Nov 2025: Prostate Cancer U.S. Mortality Trends Update

• 1 Nov 2025: Movember 2025: The Need Continues

• 2 Dec 2025: Giving Tuesday 2025: Movember and Bridge to Enter Advanced Math

• 27 Nov 2025: Men and Suicide

• 22 May 2025: President Biden Had Followed Bad Prostate Cancer Screening Guidelines -- Here are Better Ones

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